The change of cardiac axis deviation in catheter ablation of verapamil‐sensitive idiopathic left ventricular tachycardia
- 9 February 2021
- journal article
- research article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 44 (4), 685-692
- https://doi.org/10.1111/pace.14192
Abstract
Background The underlying mechanism of verapamil‐sensitive idiopathic left ventricular tachycardia (ILVT) has been postulated to be reentrant activation in the Purkinje fiber network of the left posterior fascicle (LPF) or the left anterior fascicle (LAF). However, changing of cardiac axis deviation in sinus rhythm (SR) or during ILVT after radiofrequency catheter ablation (RFCA) has been rarely analyzed. Methods Of the 232 patients with sustained ILVT induced and surface electrocardiogram (ECG) in SR recorded before and after RFCA, the changes of ECG morphology in SR and during ILVT were analyzed. Results The surface ECG in SR changed in 114 (49.1%) patients after RFCA. ILVT could still be induced in 27 (23.7%) patients. In comparison with the original ILVT, 3 forms of ECG morphology were observed. In 8 patients the ILVT morphology was unchanged. In the 13 patients with ILVT axis deviation conversion after ablation, the successful target was more proximal. In the 6 patients with ILVT morphology change but without axis deviation conversion after ablation, the successful ablation site was more distal. Among 15 patients with recurrent ILVT during follow‐up, 7 patients had previous axis deviation changes in SR after RFCA, the changes maintained in 4 patients and recovered in 3 patients. Conclusions The morphology changes on surface ECG in SR after RFCA wouldn't be a necessary prerequisite or a good endpoint for ILVT ablation. To analyze ILVT morphology changes after ablation would help to further clarify an appropriate approach for catheter ablation of ILVT. This article is protected by copyright. All rights reservedKeywords
Funding Information
- National Key Research and Development Program of China (2016YFC0900904)
- Natural Science Foundation of Liaoning Province (2019‐MS‐354)
This publication has 22 references indexed in Scilit:
- AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part III: Intraventricular Conduction Disturbances A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society Endorsed by the International Society for Computerized ElectrocardiologyJournal of the American College of Cardiology, 2009
- The Morphology Changes in Limb Leads after Ablation of Verapamil-Sensitive Idiopathic Left Ventricular Tachycardia and Their Correlation with RecurrenceJournal of Cardiovascular Electrophysiology, 2008
- Idiopathic fascicular left ventricular tachycardia: Linear ablation lesion strategy for noninducible or nonsustained tachycardiaHeart Rhythm, 2005
- Pleomorphic Ventricular Tachycardia: An Uncommon Presentation in Idiopathic Left Ventricular TachycardiaPacing and Clinical Electrophysiology, 2005
- Non-contact mapping and linear ablation of the left posterior fascicle during sinus rhythm in the treatment of idiopathic left ventricular tachycardiaEP Europace, 2005
- Electroanatomic Substrate of Idiopathic Left Ventricular TachycardiaCirculation, 2002
- Radiofrequency Ablation of Idiopathic Left Ventricular Tachycardia with Changing EGG MorphologyPacing and Clinical Electrophysiology, 1998
- Catheter Ablation of Idiopathic Left Ventricular TachycardiaPacing and Clinical Electrophysiology, 1995
- Alternation of QRS Morphology and Effect of Radiofrequency Ablation in Idiopathic Ventricular TachycardiaPacing and Clinical Electrophysiology, 1995
- Entrainment of idiopathic ventricular tachycardia of left ventricular origin with evidence for reentry with an area of slow conduction and effect of verapamilThe American Journal of Cardiology, 1988