Abstract:
INTRODUCTION:The exit site and central common pathway of slow conduction are preferred sites to guide radiofrequency ablation of postinfarction ventricular tachycardia (VT). Both require inducibility of VT. In addition, their low amplitude hampers direct recording of potentials generated by activation in pathways of slow conduction. We hypothesized that pace mapping during sinus rhythm would help to detect the VT exit site and potentials generated by activation in pathways of slow activation. METHODS AND RESULTS:In 13 patients suffering from VT late after anterior (n = 10) or inferior (n = 3) myocardial infarction, stimulation was performed in scarred endocardium at 23.5 (range 13 to 36) sites per patient during arrhythmia surgery. Multielectrode recordings (64 sites) during stimulation at a fixed cycle length of 500 msec were obtained. Endocardial breakthrough sites distant (>2 cm) from the pacing site were found at 4.3 (range 3 to 19) pacing sites per patient. Low-amplitude discrete potentials (LADPs) could be detected between the pacing site and the breakthrough site in 2.3 (range 0 to 13) of 4.3 stimulation sequences. In these patients, 19 VTs were induced and the exit site determined. In 6 patients, the distant pacing breakthrough site was identical to the VT exit site; in 7 patients, no similar exit sites were found. LADPs during VT were found at a median 2.0 (range 0 to 14) sites per patient. CONCLUSION:Pace mapping of the postinfarction endocardial scar during sinus rhythm revealed 50% of the endocardial exit sites of VT and the same number of LADPs observed during VT.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
van Dessel PF,de Bakker JM,van Hemel NM,Linnenbank AC,Jessurun ER,Defauw JAdoi
10.1046/j.1540-8167.2001.00662.xkeywords:
subject
Has Abstractpub_date
2001-06-01 00:00:00pages
662-70issue
6eissn
1045-3873issn
1540-8167journal_volume
12pub_type
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更新日期:2015-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00026.x
更新日期:2001-01-01 00:00:00
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