UMEM Educational Pearls

Ventricular Arrhythmias Originating from the Moderator Band

- Ventricular arrhythmias originating from the moderator band (MB) often have a distinct morphology

- Typically MB arrhythmias have a left bundle branch block pattern, QRS with a late precordial transition (>V4), a rapid down stroke of the QRS in the precordial leads, and a left superior frontal plane axis

- MB arrhythmias are often associated with PVC-induced ventricular fibrillation

- Catheter ablation is quite effective at termination of the arrhythmias and facilitated with intracardiac echocardiography (ICE)

References

Sadek M, Benhayon D, et al. Idiopathic ventricular arrhythmias originating from the moderator band: Electrocardiographic characteristics and treatment by catheter ablation. Heart Rhythm. Aug 2014