Document Detail

Accuracy of the unipolar electrogram for identification of the site of origin of ventricular activation.
MedLine Citation:
PMID:  9300293     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The purpose of this study was to determine the accuracy of the unipolar electrogram for identifying the earliest site of ventricular activation. The earliest site of ventricular activation may be identified with the unipolar electrogram by the absence of an R wave. However, the accuracy of this technique is unknown. METHODS AND RESULTS: A single ventricular premature complex was induced mechanically at the tip of an electrode catheter to simulate a ventricular premature depolarization site of origin. Unipolar electrograms were recorded from the right ventricular septum at the tip electrode and at 2, 5, 8, and 11 mm from the electrode tip in 20 patients. No R waves were detected at the ventricular premature depolarization site of origin. R waves were detected in 4 of 20 patients (20%) at 2 mm from the tip electrode and 7 of 20 patients (35%) at 5, 8, and 11 mm from the tip electrode. An R wave was not observed at distances < or = 11 mm from the site of tachycardia origin in 13 of 20 patients (65%). CONCLUSIONS: While an R wave in the unipolar electrogram can be seen as close as 2 mm from the site of impulse origin, the absence of an R wave as an indicator of the site of impulse origin in the right ventricle is highly inaccurate. Therefore, the absence of an R wave in the unipolar electrogram is unlikely to be an adequate guide for identification of an effective target site for ablation of right ventricular tachycardia.
K C Man; E G Daoud; B P Knight; M Bahu; R Weiss; A Zivin; S J Souza; R Goyal; S A Strickberger; F Morady
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  8     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  1997 Sep 
Date Detail:
Created Date:  1997-11-04     Completed Date:  1997-11-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  974-9     Citation Subset:  IM    
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0022, USA.
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MeSH Terms
Catheter Ablation
Diagnostic Errors
Electrocardiography / instrumentation,  methods*
Electrophysiology / instrumentation,  methods
Middle Aged
Pilot Projects
Ventricular Dysfunction, Right / diagnosis,  surgery
Ventricular Premature Complexes / diagnosis*,  surgery

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