Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 May 6;51(18):1794-802.
doi: 10.1016/j.jacc.2008.01.046.

Post-infarction ventricular arrhythmias originating in papillary muscles

Frank Bogun  1 , Benoit Desjardins, Thomas Crawford, Eric Good, Krit Jongnarangsin, Hakan Oral, Aman Chugh, Frank Pelosi, Fred Morady
Affiliations
Free article

Post-infarction ventricular arrhythmias originating in papillary muscles

Frank Bogun et al. J Am Coll Cardiol. .
Free article

Abstract

Objectives: The aim of this study was to define the role of papillary muscles (PAPs) in post-infarction ventricular arrhythmias.

Background: Papillary muscles have been implicated in arrhythmogenesis; however, their role in post-infarction ventricular arrhythmias has not been well-defined.

Methods: In a series of 9 patients (age 65 +/- 9 years, ejection fraction 0.36 +/- 0.1) with post-infarction ventricular arrhythmias, electroanatomic mapping in conjunction with intracardiac echocardiography demonstrated that 1 of the PAPs was involved in the arrhythmia. Magnetic resonance imaging with delayed enhancement (DEMRI) was performed in all patients without contraindications. A consecutive series of 9 patients (age 64 +/- 8 years, ejection fraction 0.32 +/- 0.14) with ventricular arrhythmias that did not originate from the PAP served as a control group and also underwent DEMRI.

Results: Heterogeneous uptake of gadolinium during magnetic resonance imaging was observed more frequently in arrhythmogenic PAPs than in PAPs that were not involved in ventricular arrhythmias (p = 0.01). The PAPs in the control patients did not take up contrast or show homogeneous contrast uptake. Radiofrequency ablation eliminated all arrhythmias originating from PAPs. Echocardiography after the ablation showed no new or worsened mitral regurgitation.

Conclusions: Papillary muscles that lie within an infarct zone might give rise to ventricular arrhythmias. Heterogeneous uptake of gadolinium in magnetic resonance images might be predictive of arrhythmogenic PAPs. Radiofrequency catheter ablation of ventricular tachycardia and ventricular ectopy arising in a PAP has a high success rate.

PubMed Disclaimer

MeSH terms