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\begin{document}

\title{Electrocardiographic and Electrophysiological Characteristics of
Idiopathic Ventricular Arrhythmias Ablated Through a Percutaneous
Trans-pericardial Approach}



\author[1]{Weizhu Ju}%
\author[2]{jinlin zhang}%
\author[1]{Linsheng Shi}%
\author[1]{Kai Gu}%
\author[3]{Ming Chu}%
\author[4]{Hongwu Chen}%
\author[3]{Gang Yang}%
\author[5]{Mingfang Li}%
\author[3]{Hailei Liu}%
\author[4]{Fengxiang Zhang}%
\author[6]{Bing YANG}%
\author[1]{Minglong Chen}%
\affil[1]{Institution of Clinical cardiovascular center}%
\affil[2]{Wuhan Asian Heart Hospital}%
\affil[3]{the First Affiliated Hospital of Nanjing Medical University}%
\affil[4]{Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital}%
\affil[5]{the First Affiliated Hospital of Nanjing Medical Universit}%
\affil[6]{Shanghai East Hospital}%


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  \date{May 16, 2024}


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\selectlanguage{english}
\begin{abstract}
Aims Idiopathic epicardial ventricular arrhythmias (VAs) are clustered
in the areas of the summit and crux. This study was to report a group of
idiopathic epicardial VAs remote from the summit and crux areas. Methods
In total, 9 patients (6 males, mean age 32\selectlanguage{ngerman}±13 years) were enrolled. The
locations were identified by epicardial mapping and ablation. The
electrocardiographic and electrophysiological characteristics were
compared to those of 9 patients who had VAs ablated at the opposite
endocardial site. Results VAs were identified at the epicardium, with 4
patients had VAs located at the inferior wall, one at the anterior wall,
one at the apex and 3 patients had VAs at the lateral wall. A ``QS''
type at the location-related leads was the only identified surface
electrocardiogram indication suggesting epicardial origin (compared to
that of the controls, 100\% vs 0\%, p\textless{}0.001). Endocardial and
epicardial mapping revealed pre-maturities of -11±4 ms and -25±8 ms,
respectively (VS. -28±8 ms revealed by endocardial mapping in control
patients, p\textless{}0.001 and p=0.389, respectively). All of the study
cases demonstrated an ``rS'' pattern in the endocardial unipolar
electrogram. Acute and long-term successful ablation (a median of 11
months of follow-up) was achieved in all patients without complications.
Conclusion A distinct group of idiopathic VAs remote from the summit and
crux areas warranting ablation by a subxiphoid approach were identified.
Morphological ECG features of a ``QS'' type among the location-related
grouped leads combined with the mapping findings helped in the
identification of the epicardial site of origin.%
\end{abstract}\selectlanguage{ngerman}%



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\verb`manuscript.docx`  available at \url{https://authorea.com/users/320618/articles/531696-electrocardiographic-and-electrophysiological-characteristics-of-idiopathic-ventricular-arrhythmias-ablated-through-a-percutaneous-trans-pericardial-approach}

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