Clinical, electrocardiographic, and electrophysiological characteristics of left upper septal fascicular ventricular tachycardia
| Autor: | Feifan Ouyang, Xiao-Gang Guo, Jian-Du Yang, Shu Zhang, Bin Luo, Gong-Bu Zhou, Qi Sun, Jian Ma, Xu Liu |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Tachycardia medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Diastole Action Potentials 030204 cardiovascular system & hematology Purkinje Fibers Electrocardiography 03 medical and health sciences QRS complex 0302 clinical medicine Heart Rate Predictive Value of Tests Physiology (medical) Internal medicine Heart rate medicine Humans Sinus rhythm cardiovascular diseases 030212 general & internal medicine Retrospective Studies medicine.diagnostic_test business.industry Middle Aged Right bundle branch block Ablation medicine.disease Treatment Outcome Catheter Ablation Tachycardia Ventricular Cardiology Female medicine.symptom Electrophysiologic Techniques Cardiac Cardiology and Cardiovascular Medicine business |
| Zdroj: | EP Europace. 20:673-681 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Aims We sought to investigate the clinical, electrocardiographic, and electrophysiological characteristics of left upper septal fascicular ventricular tachycardia (LUS-VT). Methods and results Eleven consecutive patients with LUS-VT were identified among 196 patients with left fascicular ventricular tachycardia (VT). Clinical VTs presented as paroxysmal in 8 patients and incessant in 3 patients. Six patients had previous left posterior fascicular VT ablation history. All VTs had narrow QRS complexes with QRS duration of 101.1 ± 9.2 ms. The frontal QRS axis was normal or right deviation. Precordial morphology was either right bundle branch block type or similar to that of sinus rhythm. A retrograde His with H-V interval of 21.9 ± 7.2 ms was recorded during VT. The earliest Purkinje potential (PP) to QRS interval during VT averaged 35.7 ± 4.5 ms. Clear diastolic potentials (DPs) with high frequency and low amplitude were found in only one patient. Ten patients were managed successfully by 11 ablation sessions, and 1 patient declined ablation. Successful targets at the left upper septum were sites with the earliest PP (9 cases) or with DP (1 case) during VT. After ablation, 2 cases (10%) developed new left anterior hemiblock or incomplete left bundle branch block. No VT recurred during a median follow-up period of 3.2 (range 1.0-12.7) years. Conclusion LUS-VT presented as narrow QRS complex tachycardia. Some LUS-VTs occurred after ablation targeting left posterior fascicular VT. The VTs can be managed successfully by focal ablation at the left upper septum with a mild risk of fascicular injury. |
| Databáze: | OpenAIRE |
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