| Mechanical interruption of postinfarction ventricular tachycardia as a guide for catheter ablation. | |
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MedLine Citation:
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PMID: 15992721 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Mechanical trauma has been described as a helpful guide for ablation of atrial tachycardias and accessory pathways. In postinfarction ventricular tachycardia (VT), the reentrant circuit is partly endocardial and therefore may be susceptible to catheter trauma. OBJECTIVES: The purpose of this study was to determine the prevalence and significance of VT termination resulting from catheter trauma. METHODS: A consecutive series of 39 patients (mean age 68 +/- 7 years, ejection fraction 0.25 +/- 0.02) underwent left ventricular mapping for postinfarction VT. Mapping was performed during 62 hemodynamically tolerated VTs (mean cycle length 451 +/- 88 ms). Only hemodynamically tolerated VTs that did not terminate spontaneously and VTs that were reproducibly inducible were included in the study. VT termination was considered mechanical only if it was not caused by a premature depolarization. RESULTS: In 13 of 62 VTs (21%) in 8 of 39 patients (21%), either VT terminated during catheter placement at a particular site (n = 7) or a previously reproducibly inducible VT became no longer inducible with the mapping catheter located at a particular site (n = 6). The stimulus-QRS interval was significantly shorter at sites where mechanical trauma affected the reentrant circuit compared with sites having concealed entrainment (102 +/- 56 ms vs 253 +/- 134 ms, P = .003). At the site that was susceptible to mechanical trauma, the pace map was identical or highly similar in 13 of 13 VTs. After radiofrequency ablation at these sites, the targeted VTs were no longer inducible. No patient had recurrence of the targeted VT during a mean follow-up of 15 +/- 11 months. CONCLUSIONS: Catheter contact at a critical endocardial site can interrupt postinfarction VT or prevent its induction. Radiofrequency ablation at sites of mechanical termination of VT has a high probability of success. |
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Authors:
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Frank Bogun; Eric Good; Jihn Han; Kamala Tamirisa; Stephen Reich; Darryl Elmouchi; Petar Igic; Kristina Lemola; Hakan Oral; Aman Chugh; Frank Pelosi; Fred Morady |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 2 ISSN: 1547-5271 ISO Abbreviation: Heart Rhythm Publication Date: 2005 Jul |
Date Detail:
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Created Date: 2005-07-04 Completed Date: 2005-10-27 Revised Date: 2009-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 687-91 Citation Subset: IM |
Affiliation:
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Division of Cardiology, University of Michigan Medical Center, Ann Arbor, Michigan 48109-0366, USA. fbogun@umich.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Catheter Ablation / methods* Electrodes Endocardium / physiopathology* Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / complications* Physical Stimulation Prospective Studies Tachycardia, Ventricular / etiology*, physiopathology, surgery* |
| Comments/Corrections | |
Comment In:
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Heart Rhythm. 2005 Jul;2(7):692-3
[PMID:
15992722
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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