Document Detail

Electrocardiographic and electrophysiologic characteristics of ventricular tachycardia originating within the pulmonary artery.
MedLine Citation:
PMID:  15766825     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We investigated the electrocardiographic (ECG) and electrophysiologic characteristics of ventricular tachycardia (VT) originating within the pulmonary artery (PA). BACKGROUND: Radiofrequency catheter ablation (RFCA) is routinely applied to the endocardial surface of the right ventricular outflow tract (RVOT) in patients with idiopathic VT of left bundle branch block morphology. It was recently reported that this arrhythmia may originate within the PA. METHODS: Activation mapping and ECG analysis were performed in 24 patients whose VTs or ventricular premature contractions (VPCs) were successfully ablated within the PA (PA group) and in 48 patients whose VTs or VPCs were successfully ablated from the endocardial surface of the RVOT (RV-end-OT group). RESULTS: R-wave amplitudes on inferior ECG leads, aVL/aVR ratio of Q-wave amplitude, and R/S ratio on lead V(2) were significantly larger in the PA group than in the RV-end-OT group. On intracardiac electrograms, atrial potentials were more frequently recorded in the PA group than in the RV-end-OT group (58% vs. 12%; p < 0.01). The amplitude of local ventricular potentials recorded during sinus rhythm within the PA was significantly lower than that recorded from the RV-end-OT (0.62 +/- 0.56 mV vs. 1.55 +/- 0.88 mV; p < 0.01). CONCLUSIONS: Ventricular tachycardia originating within the PA has different electrocardiographic and electrophysiologic characteristics from that originating from the RV-end-OT. When mapping the RVOT area, the catheter may be located within the PA if a low-voltage atrial or local ventricular potential of <1-mV amplitude is recorded. Heightened attention must be paid if RFCA is required within the PA.
Yukio Sekiguchi; Kazutaka Aonuma; Atsushi Takahashi; Yasuteru Yamauchi; Hitoshi Hachiya; Yasuhiro Yokoyama; Yoshito Iesaka; Mitsuaki Isobe
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  45     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-15     Completed Date:  2005-06-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  887-95     Citation Subset:  AIM; IM    
Cardiovascular Center, Yokosuka Kyosai General Hospital, Kanagawa, Japan.
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MeSH Terms
Bundle-Branch Block / diagnosis,  surgery
Catheter Ablation
Coronary Angiography
Electrophysiologic Techniques, Cardiac*
Heart Conduction System / pathology,  surgery
Heart Ventricles / pathology,  surgery
Middle Aged
Pulmonary Artery / pathology*,  surgery
Tachycardia, Ventricular / diagnosis*,  surgery
Treatment Outcome
Ventricular Outflow Obstruction / diagnosis,  surgery

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

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