Ventricular tachycardia originating from the aortic sinus cusp in patients with idiopathic dilated cardiomyopathy.
BACKGROUND
Ventricular tachycardia (VT) in patients with idiopathic dilated cardiomyopathy often originates from the basal left ventricular myocardium and also can originate from the conduction system. The basal left ventricular myocardium reaches to the base of the aortic sinus cusps.


OBJECTIVE
The purpose of this study was to assess the prevalence of VT originating from the aortic sinus cusps in patients with idiopathic dilated cardiomyopathy.


METHODS
Thirty-three consecutive patients with nonischemic cardiomyopathy (24 men, age: 59 ± 11 years, ejection fraction: 29% ± 14%) were referred for ablation.


RESULTS
VTs originating from the aortic sinus cusps were identified in 8 of 33 patients (24%). The presence of low voltage in the basal left ventricle correlated with the inducibility of aortic sinus cusp VTs. All but 1 aortic sinus cusp VTs were effectively ablated. In 1 patient, the site of origin of the VT was <10 mm from the ostium of the left main coronary artery and ablation was not attempted.


CONCLUSIONS
In patients with idiopathic dilated cardiomyopathy, VT often originates from the aortic sinus cusps. The large majority of these VTs can be successfully ablated.
Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Miki
M
Yokokawa
Eric
E
Good
Thomas
T
Crawford
Krit
K
Jongnarangsin
Aman
A
Chugh
Frank
F
Pelosi
Hakan
H
Oral
Fred
F
Morady
Frank
F
Bogun
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000453:epidemiology* / Q000503:physiopathology; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012850:Sinus of Valsalva; D017180:Tachycardia, Ventricular / Q000453:epidemiology* / Q000503:physiopathology