| Twelve-lead electrocardiographic characteristics of the aortic cusp region guided by intracardiac echocardiography and electroanatomic mapping. | |
| | |
MedLine Citation:
|
PMID: 18452867 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The most common site of origin of idiopathic ventricular tachycardia (VT) is the right ventricular outflow tract. Idiopathic VT also can arise from the left ventricular outflow tract and the surrounding structures. Morphologic descriptions of 12-lead ECG characteristics of the aortic cusp region are limited. OBJECTIVE: The purpose of this study was to define unique ECG characteristics of the aortic cusp region by performing a systematic analysis of pacemapping of this region in patients with structurally normal hearts. METHODS: A combination of electroanatomic mapping, intracardiac echocardiography, and fluoroscopic guidance was used to study a total of 30 patients with structurally normal hearts undergoing left-sided ablation procedures. Each of the aortic valve cusps and the aortomitral continuity were paced at threshold and analyzed offline to determine unique ECG characteristics. RESULTS: Pacing from the left coronary cusp typically produced a multiphasic QRS morphology consistent with an M or W pattern in lead V(1) with a precordial transition (R>S) no later than V(2). Pacing from the right coronary cusp typically resulted in a left bundle-type pattern with a broad small R wave in V(2) and a precordial transition generally at V(3). Pacing from the aortomitral continuity resulted in a qR pattern that was not observed anywhere else in the left ventricular outflow tract. When comparing the right coronary cusp and left coronary cusp, the precordial transition was earlier in the left coronary cusp than in the right coronary cusp. Pacing the noncoronary cusp uniformly resulted in atrial capture. CONCLUSION: When considering ablation of idiopathic VT, the aortic cusps and aortomitral continuity must be considered as possible foci. The 12-lead ECG, a readily and easily obtainable source of information, has useful characteristics for differentiating VTs arising from the cusp region. |
| | |
Authors:
|
David Lin; Leonard Ilkhanoff; Edward Gerstenfeld; Sanjay Dixit; Stuart Beldner; Rupa Bala; Fermin Garcia; David Callans; Francis E Marchlinski |
Related Documents
:
|
1658897 - Frequency analysis of the human and swine electrocardiogram during ventricular fibrilla... 9255687 - Radiofrequency catheter ablation of sustained monomorphic ventricular tachycardia in hy... 3739917 - Immediate reproducibility of clinical and nonclinical forms of induced ventricular tach... 18234007 - Qt/rr relationship in patients after remote anterior myocardial infarction with left ve... 19366447 - Coronary artery dissection and acute myocardial infarction following blunt chest trauma. 18379307 - Acute chest pain with normal coronary angiogram: role of contrast-enhanced multidetecto... |
Publication Detail:
|
Type: Comparative Study; Journal Article Date: 2008-02-09 |
Journal Detail:
|
Title: Heart rhythm : the official journal of the Heart Rhythm Society Volume: 5 ISSN: 1556-3871 ISO Abbreviation: Heart Rhythm Publication Date: 2008 May |
Date Detail:
|
Created Date: 2008-05-02 Completed Date: 2008-06-17 Revised Date: 2009-10-27 |
Medline Journal Info:
|
Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
|
Languages: eng Pagination: 663-9 Citation Subset: IM |
Affiliation:
|
Cardiovascular Division, Section of Electrophysiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. david.lin@uphs.upenn.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aortic Valve / anatomy & histology* Body Surface Potential Mapping* Catheter Ablation Echocardiography / methods* Electrocardiography* Female Humans Male Middle Aged Tachycardia, Ventricular / therapy |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Left atrial function and scar after catheter ablation of atrial fibrillation.
Next Document: High amplitude T-wave alternans precedes spontaneous ventricular tachycardia or fibrillation in ICD ...