Document Detail


Electrogram characteristics in postinfarction ventricular tachycardia: effect of infarct age.
MedLine Citation:
PMID:  16098433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to correlate infarct age with characteristics of the endocardial electrograms (EGM) obtained in patients undergoing mapping procedures for postinfarction ventricular tachycardia (VT). BACKGROUND: Experimental studies have demonstrated that infarct age influences EGM duration in the subepicardial left ventricle (LV). The relationship between infarct age and endocardial EGM characteristics has not been investigated in patients with postinfarction VT. METHODS: In a consecutive series of 23 patients with a history of remote infarction (range 1 to 31 years) and VT, endocardial LV mapping was performed with an electroanatomical mapping system (CARTO, Biosense Webster Inc., Diamond Bar, California) during sinus rhythm. Electrogram morphology and width were analyzed and correlated with infarct age. Isthmus sites of the VT re-entry circuits were identified by entrainment mapping and related to the results of substrate mapping. RESULTS: There was a significant correlation between infarct age and width of the bipolar endocardial EGM during baseline rhythm in the peri-infarct zone (r = 0.84; p < 0.0001). Increasing infarct age was associated with progressive activation delays in the scar and with isolated potentials separated by an isoelectric interval, the duration of which also correlated with infarct age (r = 0.77; p < 0.001). Among all endocardial sites, the VT isthmus sites displayed the most delay and broadest EGMs during sinus rhythm. CONCLUSIONS: The presence of broad, fractionated EGMs and isolated potentials indicates a healed myocardial infarction; the older the infarction, the broader the EGM width. Remodeling over time alters the electrophysiologic properties of the peri-infarct tissue.
Authors:
Frank Bogun; Subramaniam Krishnan; Mukarram Siddiqui; Eric Good; Joseph E Marine; Claudio Schuger; Hakan Oral; Aman Chugh; Frank Pelosi; Fred Morady
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  46     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-15     Completed Date:  2005-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  667-74     Citation Subset:  AIM; IM    
Affiliation:
University of Michigan Medical Center, Ann Arbor, Michigan, USA. fbogun@umich.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Body Surface Potential Mapping
Catheter Ablation
Disease Progression
Electrocardiography*
Electrophysiology
Female
Heart Conduction System / physiopathology
Humans
Male
Middle Aged
Myocardial Infarction / physiopathology*
Prospective Studies
Tachycardia, Ventricular / diagnosis*,  physiopathology
Time Factors
Ventricular Remodeling / physiology*
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2005 Aug 16;46(4):675-7   [PMID:  16098434 ]

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


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