| Septal involvement in patients with post-infarction ventricular tachycardia: implications for mapping and radiofrequency ablation. | |
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MedLine Citation:
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PMID: 22133849 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The purpose of this study was to assess the prevalence of the re-entry circuit within the interventricular septum in post-infarction patients referred for ventricular tachycardia (VT) ablation. BACKGROUND: Post-infarction ventricular tachycardia can involve the endocardial myocardium, the intramural myocardium, the epicardium, or the His Purkinje system. METHODS: Among 74 consecutive patients with recurrent post-infarction VT, 33 patients (45%) were identified in whom the critical part of the VT involved the interventricular septum. A total of 206 VTs were induced in these 33 patients. In 46 of the 206 VTs, a critical component was identified in the interventricular septum. The critical isthmus of the re-entry circuit was identified by entrainment mapping, activation mapping, or pace-mapping. RESULTS: In 32 of 46 VTs (70%), the critical component of the re-entry circuit was confined to the endocardium. In 9 of 46 VTs (20%), the critical component involved the Purkinje system, and in 5 of 46 VTs (11%), an intramural area was critical. Entrainment and/or pace-mapping helped to identify critical areas of endocardial VTs as well as VTs involving the Purkinje fibers, but neither of these mapping techniques localized intramural VTs. Electrocardiographic characteristics were specific for each of the septal locations. All VTs mapped to the interventricular septum were acutely successfully ablated. VTs recurred in 9 of 33 patients with septal VTs during a mean follow-up period of 40 ± 20 months. CONCLUSIONS: Post-infarction VT involving the interventricular septum can involve the endocardial muscle, Purkinje fibers, or intramural muscle fibers. Electrocardiographic characteristics differ depending on the type of tissue involved. |
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Authors:
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Kentaro Yoshida; Miki Yokokawa; Benoit Desjardins; Eric Good; Hakan Oral; Aman Chugh; Frank Pelosi; Fred Morady; Frank Bogun |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 58 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-02 Completed Date: 2012-01-18 Revised Date: 2013-04-01 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 2491-500 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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University of Michigan Medical Center, Ann Arbor, MI 48109, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Catheter Ablation* Electrocardiography Electrophysiologic Techniques, Cardiac* Endocardium / physiopathology Female Heart Conduction System / physiopathology Humans Magnetic Resonance Imaging Male Middle Aged Myocardial Infarction / complications* Purkinje Fibers / physiopathology Tachycardia, Ventricular / etiology, physiopathology, surgery* Ventricular Septum / physiopathology* |
| Grant Support | |
ID/Acronym/Agency:
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K23 EB006481/EB/NIBIB NIH HHS; K23 EB006481-05/EB/NIBIB NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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