Document Detail


Ablation of idiopathic ventricular tachycardia in two separate regions of the outflow tract: prevalence and electrocardiographic characteristics.
MedLine Citation:
PMID:  17302726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Few studies have clarified the prevalence and characteristics of idiopathic outflow tachycardia (OT-VT) with an altered QRS morphology after radiofrequency catheter ablation (RFCA), requiring additional RFCA applications at a different portion of the outflow tract (OT) to abolish the OT-VT. Among 344 patients (97 VTs and 247 premature ventricular contractions), 12 (3.5%; VTs-7, PVCs-5; 6 women) had dynamic QRS morphology changes following the RFCA, requiring additional RFCA applications at a different portion to abolish the OT-VT. In 8 of 12 patients (67%), this phenomenon occurred following RFCA at right (RVOT; n = 7) or left ventricular (LVOT; n = 1) endocardial sites of the OT: The second OT-VT was consistently associated with an increase in the R-wave amplitude in the inferior leads, and in five it was finally abolished by RFCA at the left sinus of Valsalva (LSV). Conversely, in four patients (33%), the second OT-VT appeared after RFCA at the LSV: two required additional RFCA applications at the LVOT to abolish the second OT-VT, and one at the RVOT, and all were associated with a decrease in the R-wave amplitude in the inferior leads. This kind of dynamic QRS morphology change was often observed when RFCA was applied to either the first or second OT-VT at a right or left ventricular endocardial site, with the other site being the LSV. A detailed continuous observation of the QRS morphology, especially of the R-wave in the inferior leads, is important for identifying changes in the QRS morphology during RFCA.
Authors:
Kenichi Kaseno; Hiroshi Tada; Sachiko Ito; Kazuyoshi Tadokoro; Tohru Hashimoto; Kohei Miyaji; Shigeto Naito; Shigeru Oshima; Akihiko Nogami; Koichi Taniguchi
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  30 Suppl 1     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-02-16     Completed Date:  2007-06-12     Revised Date:  2008-01-18    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S88-93     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Catheter Ablation*
Electrocardiography / methods*
Female
Humans
Male
Middle Aged
Tachycardia, Ventricular / diagnosis,  physiopathology*,  surgery*
Ventricular Dysfunction, Left
Ventricular Dysfunction, Right
Comments/Corrections
Erratum In:
Pacing Clin Electrophysiol. 2007 Nov;30(11):1426

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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