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Gepubliceerd in:

01-02-2010 | imaging in cardiology

Entrainment mapping of ventricular tachycardia

Auteurs: M. C. Post, E. G. Mast, E. Stel, E. F. D. Wever

Gepubliceerd in: Netherlands Heart Journal | Uitgave 2/2010

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Extract

A 64-year-old male, with a history of a lateral myocardial infarction, presented with haemodynamically well-tolerated incessant therapy-resistant slow monomorphic ventricular tachycardia (mVT), despite implantable cardioverter defibrillator and antiarrhythmic drugs. The mechanism of this mVT was probably scar-related reentry.1 According to the guidelines, catheter ablation was indicated in our patient.2 During pacing and sustained mVT, entrainment mapping was performed at a site where the catheter recorded diastolic potentials (DP) (figure 1A). Entrainment with concealed fusion occurred: the morphology of the QRS complex during pacing was identical to the mVT morphology, the interval from stimulus to QRS complex was similar to the interval from DP to QRS complex, and post-pacing interval was the same as the cycle length of the VT (figure 2).3,4 Radiofrequency catheter ablation on this critical point within the reentry circuit terminated the mVT successfully (figure 1B). The patient remained free of VT recurrences afterwards.
Literatuur
1.
go back to reference de Bakker JM, van Capelle FJ, Janse MJ, et al. Reentry as a cause of ventricular tachycardia in patients with chronic ischemic heart disease: electrophysiologic and anatomic correlation. Circulation. 1988;77:589–606. de Bakker JM, van Capelle FJ, Janse MJ, et al. Reentry as a cause of ventricular tachycardia in patients with chronic ischemic heart disease: electrophysiologic and anatomic correlation. Circulation. 1988;77:589–606.
2.
go back to reference Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114:e385–e484. Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114:e385–e484.
3.
go back to reference Almendral JM, Gottlieb CD, Rosenthal ME, et al. Entrainment of ventricular tachycardia: explanation for surface electrocardiographic phenomena by analysis of electrograms recorded within the tachycardia circuit. Circulation. 1988;77:569–80. Almendral JM, Gottlieb CD, Rosenthal ME, et al. Entrainment of ventricular tachycardia: explanation for surface electrocardiographic phenomena by analysis of electrograms recorded within the tachycardia circuit. Circulation. 1988;77:569–80.
4.
go back to reference Das MK, Dandamudi G, Steiner H. Role of ablation therapy in ventricular arrhythmias. Cardiol Clin. 2008;26:459–79, vii. Das MK, Dandamudi G, Steiner H. Role of ablation therapy in ventricular arrhythmias. Cardiol Clin. 2008;26:459–79, vii.
Metagegevens
Titel
Entrainment mapping of ventricular tachycardia
Auteurs
M. C. Post
E. G. Mast
E. Stel
E. F. D. Wever
Publicatiedatum
01-02-2010
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 2/2010
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/BF03091746