Title of article :
Localization of the Return Pathway in Ischemic Ventricular Tachycardi by Diastolic Potential Mapping
Author/Authors :
Junichi Saito، نويسنده , , Eugene Downar، نويسنده , , J. Colin Doig، نويسنده , , Louise Harris، نويسنده , , Lind Mickleborough، نويسنده , , Stephane Masse، نويسنده , , Elias Sevaptsidis، نويسنده , , Mei-Hao Shi، نويسنده , , Shane Kimber، نويسنده , , Thomas C. K. Chen، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 1995
Pages :
1
From page :
19
To page :
19
Abstract :
Successful treatment of ischemic VT, including by catheter ablation, requires accurate interpretation of the local electrograms. Diastolic potentials may be recorded over wide are of the endocardium. This study investigated the relationship of the return pathway in VT to the are displaying diastolic activity. 78 VTs in 30 patients were mapped endocardially at time of surgery. Complete return pathways were seen in 17 VTs of 10 patients. The return pathway was defined by tracking diastolic potentials from the earliest diastolic signal towards the site of VT origin. Conduction time over the return pathway represented the diastolic interval. The are of diastolic activity was determined by calculating the are enclosed by electrodes showing diastolic potentials from an inflated endocardial balloon. Result: The mean return pathway conduction time was 90 ± 31 ms (range 40-140 ms). Mean diastolic interval was 64 ± 23 ms (range 30-115 ms). The mean are over which diastolic activity could be seen was 317 ± 255 mm2 (range 28-920 mm2). In all 17 VTs, diastolic activity was seen within 15 mm of site of origin, and this represented an are of 98 ± 65 mm2 (range 28-170 mm2). 62% local electrograms within 15 mm of site of origin showed diastolic potential to QRS interval <70 ms. All patients with such pattern were cured by surgery, but 2 of 4 patients with diastolic potential to QRS interval ≥70 ms had VT recurrence. VT cycle length correlated with the conduction time of return pathway (R = 0.765, P = 0.0002), but not with the are of the return pathway. Implication: 1) Region exhibiting diastolic potentials was far greater than the return pathway per se. 2) Characterization of the timing of diastolic potentials relative to the QRS complex helps to identify critical portions of the return pathway close to the VT site of origin. 3) Such analysis may differentiate critical areas of the return pathway from bystander regions. 4) These observations may help direct radio-frequency ablation in the catheter laboratory.
Journal title :
JACC (Journal of the American College of Cardiology)
Serial Year :
1995
Journal title :
JACC (Journal of the American College of Cardiology)
Record number :
478344
Link To Document :
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