Document Detail


Relationship of slow conduction detected by pace-mapping to ventricular tachycardia re-entry circuit sites after infarction.
MedLine Citation:
PMID:  12628726     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study sought to characterize the relationship of conduction delays detected by pace-mapping, evident as a stimulus to QRS interval (S-QRS) delay >or=40 ms, to ventricular tachycardia (VT) re-entry circuit isthmuses defined by entrainment and ablation. BACKGROUND: Areas of slow conduction and block in old infarcts cause re-entrant VT. METHODS: In 12 patients with VT after infarction, pace-mapping was performed at 890 sites. Stimulus to QRS intervals were measured and plotted in three-dimensional reconstructions of the left ventricle. Conduction delay was defined as >or=40 ms and marked delay as >80 ms. The locations of conduction delays were compared to the locations of 14 target areas, defined as the region within a radius of 2 cm of a re-entry circuit isthmus. RESULTS: Pacing captured at 829 sites; 465 (56%) had no S-QRS delay, 364 (44%) had a delay >or=40 ms, and 127 (15%) had a delay >80 ms. Sites with delays were clustered in 14 discrete regions, 13 of which overlapped target regions. Only 1 of the 14 target regions was not related to an area of S-QRS delay. Sites with marked delays >80 ms were more often in the target (52%) than sites with delays 40 to 80 ms (29%) (p < 0.0001). CONCLUSIONS: Identification of abnormal conduction during pace-mapping can be used to focus mapping during induced VT to a discrete region of the infarct. Further study is warranted to determine if targeting regions of conduction delay may allow ablation of VT during stable sinus rhythm without mapping during VT.
Authors:
Corinna B Brunckhorst; William G Stevenson; Kyoko Soejima; William H Maisel; Etienne Delacretaz; Peter L Friedman; Shlomo A Ben-Haim
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  41     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-11     Completed Date:  2003-03-27     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:  802-9     Citation Subset:  AIM; IM    
Affiliation:
University of Zurich, Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Cardiac Pacing, Artificial*
Catheter Ablation / methods*
Electrocardiography*
Electrophysiology
Follow-Up Studies
Heart Catheterization
Heart Conduction System / physiopathology*
Humans
Male
Middle Aged
Myocardial Infarction / complications*,  diagnosis
Probability
Prospective Studies
Risk Assessment
Sampling Studies
Tachycardia, Atrioventricular Nodal Reentry / diagnosis*,  etiology,  surgery*
Treatment Outcome

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


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