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Identification of the Slow Conduction Zone in a Macroreentry Circuit of Verapamil-Sensitive Idiopathic Left Ventricular Tachycardia Using Electroanatomic Mapping.
MedLine Citation:
PMID:  22452322     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Identification of the Slow Conduction Zone in a Macroreentry.  Background: Although idiopathic left ventricular tachycardia (ILVT) has been shown to possess a slow conduction zone (SCZ), the details of the electrophysiological and anatomic aspects are still not well understood. Objective: We hypothesized that the SCZ can be identified using a 3-dimensional electroanatomic (EA) mapping system. Methods : Ten patients with ILVT were mapped using a 3-dimensional electroanatomic (EA) mapping system. After a 3-dimensional endocardial geometry of the left ventricular was created, the conduction system with left Purkinje potential (PP) and the SCZ with diastolic potential (DP) in LV were mapped during sinus rhythm (SR) and ventricular tachycardia (VT) and were tagged as special landmarks in the geometry. The electrophysiological and anatomic aspects of it were investigated. Results: EA mapping during SR and VT was successfully performed in 7 patients, during VT in 3 patients. The SCZ with DPs located at the inferoposterior septum was found in 7 patients during SR and all patients during VT. The length of the SCZ was 25.2 ± 2.3 mm with conduction velocity 0.08 ± 0.01 m/s. No differences in these parameters were found between patients during SR and VT (P > 0.05). An area with PP was found within the posterior septum. A crossover junction area with DP and PP was found in 7 patients during SR and VT. This area with DP and PP during SR coincided or were in proximity to such area during VT and radiofrequency ablation targeting the site within the area abolished VT in all patients. Conclusion: The ILVT substrate within the junction area of the SCZ and the posterior fascicular can be identified and can be used to guide the ablation of ILVT. (J Cardiovasc Electrophysiol, Vol. pp. 1-6).
Authors:
Jianmin Chu; Yufa Sun; Yingjie Zhao; Wei Wei; Jing Wang; Xiaoyan Liu; Yuhe Jia; Kexiu Mao; Jielin Pu; Shu Zhang
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-27
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
Affiliation:
Clinical EP Laboratory and Arrhythmia Service Center of Fuwai Heart Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China General Advisor Ministry of PLA, Beijing, China.
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