Journal of cardiovascular electrophysiology · 2009
New endpoint for ablation of ventricular tachycardia: change in QRS morphology with pacing at protected isthmus as index of isthmus block.
Клинический случайСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Bala Rupa, Dhruvakumar Sandhya, Latif Shuaib A, Marchlinski Francis E
Аннотация
INTRODUCTION: Endpoints confirming block in the critical isthmus in sinus rhythm and with pace mapping have not been established.
METHODS AND RESULTS: A 44-year-old man with a history of Tetralogy of Fallot presented with recurrent ventricular tachycardia (VT). Entrainment mapping was consistent with a macroreentrant circuit rotating in a clockwise fashion under the pulmonic valve. After termination of the VT in a critical isthmus located on the conal free wall, a pace map proximal to the site of successful ablation was consistent with a change in QRS morphology. This change in QRS morphology suggested critical isthmus block and successful ablation, which was confirmed by noninducibility with programmed stimulation.
CONCLUSION: Evidence of conduction block can be used as an additional endpoint for successful ablation of VT.
METHODS AND RESULTS: A 44-year-old man with a history of Tetralogy of Fallot presented with recurrent ventricular tachycardia (VT). Entrainment mapping was consistent with a macroreentrant circuit rotating in a clockwise fashion under the pulmonic valve. After termination of the VT in a critical isthmus located on the conal free wall, a pace map proximal to the site of successful ablation was consistent with a change in QRS morphology. This change in QRS morphology suggested critical isthmus block and successful ablation, which was confirmed by noninducibility with programmed stimulation.
CONCLUSION: Evidence of conduction block can be used as an additional endpoint for successful ablation of VT.