Document Detail


Resetting of ventricular tachycardia with electrocardiographic fusion: incidence and significance.
MedLine Citation:
PMID:  3342489     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The incidence and significance of fusion of the QRS complex during resetting of sustained ventricular tachycardias (VTs) was determined in 53 VTs induced by programmed stimulation in 46 patients with prior myocardial infarction. All 53 VTs were reset with one or two extrastimuli delivered at the right ventricular apex (RVA); 29 (54.7%) demonstrated fusion of the VT QRS complex coincident with the extrastimulus resetting the VT. Activation time at the RVA during VT (measured from the onset of the VT QRS complex to the first rapid deflection of the RVA electrogram) was longer in VT reset with fusion compared with those without fusion (91 +/- 30 vs 33 +/- 32 msec; p less than .001). A right bundle branch block VT QRS morphology and a rightward and inferior axis were more common in VT reset with electrocardiographic (ECG) fusion. Additionally, the shortest return cycle following the extrastimulus resetting the VT was shorter in VT reset with ECG fusion compared with those without (327 +/- 66 vs 423 +/- 84 msec; p less than .001). Fusion of the endocardial electrogram recorded at the site of VT origin was noted in 11 of 15 VTs that were reset while a recording catheter was positioned at this site, including all eight VTs with evidence of surface ECG fusion and three of seven VTs without fusion. Seventeen VTs were reset from the right ventricular outflow tract as well as the RVA; eight demonstrated QRS fusion at both sites, five from the right ventricular outflow tract only, and four from neither site.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
M E Rosenthal; N J Stamato; J M Almendral; C D Gottlieb; M E Josephson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  77     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1988 Mar 
Date Detail:
Created Date:  1988-04-04     Completed Date:  1988-04-04     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  581-8     Citation Subset:  AIM; IM    
Affiliation:
Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, Philadelphia 19104.
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MeSH Terms
Descriptor/Qualifier:
Cardiac Pacing, Artificial*
Electrocardiography*
Electrophysiology
Endocardium / physiopathology
Heart Conduction System / physiopathology*
Humans
Middle Aged
Tachycardia / physiopathology*
Grant Support
ID/Acronym/Agency:
HL07346/HL/NHLBI NIH HHS; HL24278/HL/NHLBI NIH HHS; HL28093/HL/NHLBI NIH HHS

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


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