Document Detail


Comparison of mapping criteria for hemodynamically tolerated, postinfarction ventricular tachycardia.
MedLine Citation:
PMID:  16399047     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mapping criteria for hemodynamically tolerated, postinfarction ventricular tachycardia (VT) have been evaluated in only small series of patients. OBJECTIVES: The purpose of this study was to evaluate the utility of various mapping criteria for identifying a critical VT circuit isthmus in a post hoc analysis. METHODS: Ninety VTs (cycle length 491 +/- 84 ms) were mapped in 48 patients with a prior myocardial infarction. The mapping catheter was positioned within a protected area of the reentrant circuit of the targeted VTs at 176 sites. All sites showed concealed entrainment. The predictive values of the following mapping criteria for a successful ablation site were compared: discrete isolated potential during VT, inability to dissociate the isolated potential from the VT, endocardial activation time >70 ms, matching electrogram-QRS and stimulus-QRS intervals, VT termination without global capture during pacing, stimulus-QRS/VT cycle length ratio <or=0.7, and postpacing interval. For each criterion, the receiver operating characteristic curve was constructed, and the area under the curve was calculated to assess the discriminatory value of the criterion. RESULTS: Seventy-eight of 90 VTs (87%) were successfully ablated. The area under the receiver operating characteristic curve was largest (0.89) for matching stimulus-QRS and electrogram-QRS intervals. In combination with an isolated potential that could not be dissociated from the VT, the area under the receiver operating characteristic curve increased to 0.93. CONCLUSION: At sites with concealed entrainment, matching stimulus-QRS and electrogram-QRS intervals were superior to other criteria in differentiating a critical isthmus from bystander or noncritical sites in postinfarction VT.
Authors:
Frank Bogun; Hyungjin Myra Kim; Jihn Han; Kamala Tamirissa; David Tschopp; Stephen Reich; Darryl Elmouchi; Petar Igic; Kristina Lemola; Eric Good; Hakan Oral; Aman Chugh; Frank Pelosi; Fred Morady
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  3     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-09     Completed Date:  2006-03-16     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  20-6     Citation Subset:  IM    
Affiliation:
University of Michigan Medical Center, Ann Arbor, Michigan 48109-0366, USA. fbogun@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Catheter Ablation / methods*
Electrocardiography
Electrophysiologic Techniques, Cardiac*
Female
Humans
Male
Myocardial Infarction / physiopathology
Predictive Value of Tests
ROC Curve
Sensitivity and Specificity
Tachycardia, Ventricular / physiopathology,  surgery*

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


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