Document Detail


Role of catheter mapping in the preoperative evaluation of ventricular tachycardia.
MedLine Citation:
PMID:  7053604     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although surgery is an accepted mode of therapy for refractory ventricular tachycardia, routine aneurysmectomy has yielded unpredictable results. This is believed to have occurred because there was no documentation that the arrhythmia actually arose from resected aneurysmal tissue. Catheter endocardial mapping has been used to localize preoperatively the area of origin of the arrhythmia. This technique has established that the arrhythmias arise near the endocardium at the borders of the aneurysm or infarction, or both. These regions, particularly when they occur in the interventricular septum, are not resected by standard aneurysmectomy. Intraoperative endocardial and epicardial mapping have validated the accuracy of this technique. We believe that catheter mapping should be performed before surgery for the following reasons: (1) In some patients ventricular tachycardia is not inducible in the operating room (for example, automatic ventricular tachycardia can be mapped in the catheterization laboratory); (2) in some patients not all morphologic forms of tachycardia can be induced or mapped intraoperatively because of failure of inducibility, time constraints or degeneration of the arrhythmia to ventricular fibrillation; and (3) intraoperative endocardial mapping occasionally cannot be performed because of lack of technical skills, physical factors such as mural thrombosis, or the inability to induce ventricular tachycardia after aneurysmectomy. Other methods currently being evaluated to localize the origin of ventricular tachycardia that do not require induction of arrhythmia are analysis of ventricular electrograms during sinus rhythm and pacemapping.
Authors:
M E Josephson; L N Horowitz; S R Spielman; H L Waxman; A M Greenspan
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  49     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1982 Jan 
Date Detail:
Created Date:  1982-02-25     Completed Date:  1982-02-25     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  207-20     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Cardiac Pacing, Artificial
Electrocardiography
Electrophysiology
Heart Aneurysm / complications
Heart Catheterization
Humans
Myocardial Infarction / complications
Preoperative Care
Tachycardia / diagnosis*,  etiology,  surgery
Grant Support
ID/Acronym/Agency:
1 K04 HL00361/HL/NHLBI NIH HHS; 1 R23 HL21292/HL/NHLBI NIH HHS; R01 HL24278/HL/NHLBI NIH HHS

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


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