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- Title
New Endpoint for Ablation of Ventricular Tachycardia: Change in QRS Morphology with Pacing at Protected Isthmus as Index of Isthmus Block.
- Authors
BALA, RUPA; DHRUVAKUMAR, SANDHYA; LATIF, SHUAIB A.; MARCHLINSKI, FRANCIS E.
- Abstract
New Endpoint for Ablation of Ventricular Tachycardia. 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.
- Subjects
TETRALOGY of Fallot; CARDIAC pacing; VENTRICULAR tachycardia; CATHETER ablation; BODY surface mapping; ELECTROPHYSIOLOGY; THERAPEUTICS
- Publication
Journal of Cardiovascular Electrophysiology, 2010, Vol 21, Issue 3, p320
- ISSN
1045-3873
- Publication type
Case Study
- DOI
10.1111/j.1540-8167.2009.01596.x