| Importance of recording the right bundle branch deflection in the diagnosis of His-Purkinje reentrant tachycardia. | |
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MedLine Citation:
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PMID: 1378593 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Eight of 120 consecutive patients with inducible sustained ventricular tachycardia who were studied at our institution from September 1, 1988 to January 1, 1991, were found to have reentry within the His-Purkinje System as the mechanism of their tachycardias. Two of the eight patients (25%) required the recording of the right bundle branch potential to elucidate the tachycardia circuits. The electrophysiological findings of these two patients are described. In both instances, the diagnosis of supraventricular tachycardia with aberrancy was excluded. In patient 1, a His-bundle electrogram preceded each QRS complex during tachycardia and the His-to-His interval variation preceded changes in QRS intervals. However, recordings from the right bundle branch allowed for exclusion of bundle branch reentry and evidence was found for reentry restricted to the left fascicles. In patient 2, despite instances of dissociation of the His-bundle deflection from the tachycardia, a right bundle branch potential preceded each QRS and spontaneous changes in the interval between successive activation of the right bundle branch preceded changes in ventricular activation. Catheter ablation of the right bundle branch eliminated the tachycardia. It is concluded that the recording of a right bundle branch potential should be included in electrophysiology study of patients in whom there is suspicion of reentry within the His-Purkinje System. Clinically, recognizing these forms of tachycardias can be important because they can be effectively treated with catheter ablation. |
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Authors:
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W W Chien; M M Scheinman; T J Cohen; M D Lesh |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Pacing and clinical electrophysiology : PACE Volume: 15 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 1992 Jul |
Date Detail:
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Created Date: 1992-08-14 Completed Date: 1992-08-14 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1015-24 Citation Subset: IM |
Affiliation:
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Department of Medicine, University of California, San Francisco. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Bundle of His / physiopathology* Cardiac Pacing, Artificial* Diagnosis, Differential Electrocardiography / methods* Electrophysiology Heart Catheterization Humans Male Middle Aged Purkinje Fibers / physiopathology* Tachycardia / diagnosis*, physiopathology Tachycardia, Supraventricular / diagnosis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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