Document Detail

Advances in catheter ablation use of unipolar electrograms.
MedLine Citation:
PMID:  2466257     Owner:  NLM     Status:  MEDLINE    
Ventricular tachycardia in man can be eliminated by relatively small lesions in the reentrant circuit. This report includes a review of available energy sources, and methods for localizing arrhythmias. Methods to assure contact and prevent perforation using low frequency electrograms are presented including the new finding of reverse ST deflection with contact. Experience with laser energy in dogs showed discrete homogenous lesions. When compared with DC shock the animals showed far less arrhythmia and the lack of far field effect greatly reduced echo abnormalities in the post shock period. Studies with radiofrequency show ability to produce localized lesions similar to the laser but with a more flexible catheter. Localization requires a correlation of techniques including pacemapping, activation maps and pacing during tachycardia. Early activation (less than -60 ms) at times 180-320 ms, with comparable pace to QRS during tachycardia with no change in morphology best localized the slow zone of the reentrant circuit. The low frequency unipolar electrogram from the tip and immediately proximal electrode revealed contact with ST deviation. The distal deviation was always greater than the proximal RV free wall and posterior basal produced depression rather than elevation of the electrogram. While the mechanism of ST reversal with contact is not understood and may relate to the type of indifferent reference used (Wilson central terminal), the ST depression reveals the same information about contact that elevation does in most areas of the heart studied in our patients.
R Fletcher; J Swartz; B Lee; A Cohen; M Wish; J Jones
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  12     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1989 Jan 
Date Detail:
Created Date:  1989-04-14     Completed Date:  1989-04-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  225-30     Citation Subset:  IM    
Section of Cardiology, Veterans Administration Medical Center, Washington, D.C. 20422.
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MeSH Terms
Electrocardiography / methods*
Electrocoagulation / methods*
Heart Ventricles / surgery*
Laser Therapy
Radio Waves
Tachycardia / surgery*

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

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