Document Detail

Electroanatomic mapping characteristics of ventricular tachycardia in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia.
MedLine Citation:
PMID:  16216751     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Ventricular tachycardia (VT) in arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVD) has been previously explored using entrainment mapping techniques but little is know about VT mechanisms and the characteristics of their circuits using an electroanatomical mapping system. METHODS AND RESULTS: Three-dimensional electroanatomical mapping was performed in 11 patients with well tolerated sustained VT and ARVD. Sinus rhythm mapping of the right ventricle was performed in eight patients showing areas of low bipolar electrogram voltage (<1.2 mV). In total 12 tachycardias (mean cycle length 382+/-62 ms) were induced and mapped. Complete maps demonstrated a reentry mechanism in eight VTs and a focal activation pattern in four VTs. The reentrant circuits were localized around the tricuspid annulus (five VTs), around the right ventricular outflow tract (one VT) and on the RV free lateral wall (two VTs). The critical isthmus of each peritricuspid circuit was bounded by the tricuspid annulus with a low voltage area close to it. The isthmus of tachycardia originating from the right ventricular outflow tract (RVOT) was delineated by the tricuspid annulus with a low voltage area localized on the posterior wall of the RVOT. Each right ventricular free wall circuit showed an isthmus delineated by two parallel lines of block. Focal tachycardias originated on the right ventricular free wall. Linear radiofrequency ablation performed across the critical isthmus was successful in seven of eight reentrant tachycardias. The focal VTs were successfully ablated in 50% of cases. During a follow-up of 9-50 months VT recurred in four of eight initially successfully ablated VTs. CONCLUSIONS: Peritricuspid ventricular reentry is a frequent mechanism of VT in patients with ARVD which can be identified by detailed 3D electroanatomical mapping. This novel form of mapping is valuable in identifying VT mechanisms and in guiding RF ablation in patients with ARVD.
Hielko Miljoen; Simona State; Christian de Chillou; Isabelle Magnin-Poull; Pierre Dotto; Marius Andronache; Ahmed Abdelaal; Etienne Aliot
Publication Detail:
Type:  Journal Article     Date:  2005-09-22
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  7     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-11     Completed Date:  2006-02-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  516-24     Citation Subset:  IM    
Département de Cardiologie, CHU Brabois, Rue Morvan, 54511 Vandoeuvre-les-Nancy, France.
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MeSH Terms
Arrhythmogenic Right Ventricular Dysplasia / complications*
Catheter Ablation
Electrophysiologic Techniques, Cardiac*
Heart Conduction System / physiopathology*
Heart Rate
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Middle Aged
Tachycardia, Ventricular / complications,  physiopathology*,  surgery

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