| Determinants of postinfarction ventricular tachycardia. | |
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MedLine Citation:
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PMID: 20937722 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Structural factors contributing to the development of postinfarction ventricular tachycardia (VT) are unclear. The purpose of this study was to analyze infarct architecture and electrogram characteristics in patients with and without inducible VT and to identify correlates of postinfarction VT. METHODS AND RESULTS: Twenty-four postinfarction patients (median age, 64 [53, 70] years) were referred for radiofrequency catheter ablation of VT (n = 12) or frequent symptomatic premature ventricular contractions (PVCs) (n = 12). Delayed-enhanced (DE) MRI was obtained before ablation. Electroanatomical mapping was performed and scar area and electrogram characteristics of the scar tissue compared in patients with and without inducible VT. The median ejection fraction in patients with and without inducible VT was 27% (22%, 43%) and 43% (40%, 47%), respectively (P = 0.085). Subendocardial infarct area determined by DE-MRI was larger in patients with inducible VT (43 [38, 62] cm(2)) than in those with noninducible VT (8 [4, 11] cm(2); P = 0.002), and unipolar and bipolar voltages on electroanatomical maps were significantly lower in patients with inducible VT (both P<0.05). An infarct volume of >14% identified 11 of 12 patients with inducible VT (area under the curve, 0.94; P = 0.007). On electroanatomical mapping, distinct sites with isolated potentials (IPs) were more prevalent in patients with inducible VT than in those without (13.2% versus 1.1% of points within scar; P < 0.001). The number of inducible VTs correlated with the number of distinct sites with IPs (R = 0.87; P<0.0001). CONCLUSIONS: Scar tissue in postinfarction patients with inducible VT shows quantitative and qualitative differences from scars in patients without inducible VT. Scar size and IPs are correlated with VT inducibility. |
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Authors:
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Thomas Crawford; Jennifer Cowger; Benoit Desjardins; Hyungjin Myra Kim; Eric Good; Krit Jongnarangsin; Hakan Oral; Aman Chugh; Frank Pelosi; Fred Morady; Frank Bogun |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2010-10-11 |
Journal Detail:
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Title: Circulation. Arrhythmia and electrophysiology Volume: 3 ISSN: 1941-3084 ISO Abbreviation: Circ Arrhythm Electrophysiol Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-15 Completed Date: 2011-02-23 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 101474365 Medline TA: Circ Arrhythm Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 624-31 Citation Subset: IM |
Affiliation:
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University of Michigan Medical Center, Ann Arbor, Mich 48109-5853, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Body Surface Potential Mapping / methods* Catheter Ablation / methods* Heart Ventricles / physiopathology* Humans Magnetic Resonance Imaging / methods* Middle Aged Myocardial Infarction / complications* Reproducibility of Results Tachycardia, Ventricular / diagnosis*, etiology, surgery |
| Grant Support | |
ID/Acronym/Agency:
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K23 EB006481-05/EB/NIBIB NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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