Catheter ablation of idiopathic left ventricular tachycardia with multiple breakthrough sites guided by an electroanatomical mapping system.

Idiopathic ventricular tachycardia (VT) has been considered to be amenable to radiofrequency catheter ablation guided by Purkinje potentials. However, there appear to be various types of reentrant circuits associated with this VT deduced from the results of the successful radiofrequency catheter ablation cases. We describe in this report a patient with idiopathic left ventricular tachycardia which was electrically inducible and verapamil sensitive.

Syncope in patients with atrial flutter during treatment with class Ic antiarrhythmic drugs.

We describe 2 atrial flutter (AFL) patients with syncope during treatment with class Ic antiarrhythmic drugs. During the syncope, 1:1 atrioventricular (AV) conduction during AFL preceded a wide QRS tachycardia. The class Ic drugs, flecainide and pilsicainide, slowed the atrial rate, resulting in AFL with 1:1 AV conduction, and the width of the QRS complexes became wider during the tachycardia.

Diagnostic significance of the morphological change in the atrial electrogram during Para-Hisian pacing.

Para-Hisian pacing (PHP), a pacing method to differentiate between conduction occurring over an accessory pathway (AP) from that over the atrioventricular node (AVN), is assessed essentially by comparing the timing in the atrial electrogams. Morphological change in the atrial electrograms is often observed during PHP, but its significance has not been investigated. Prior to the catheter ablation procedure, PHP was performed in 52 patients with an AP and in 36 patients with AV nodal reentrant tachycardia (AVNRT).

Slow-fast form of atrioventricular nodal reentrant tachycardia with eccentric retrograde left-sided activation.

A case of atypical AV nodal reentrant tachycardia (AVNRT) with eccentric retrograde left-sided activation, masquerading as tachycardia using a left-sided accessory pathway, is reported. Initially, it appeared that the tachycardia was a typical slow-fast form of AVNRT. The earliest retrograde activation, however, was registered at a site approximately 3 cm from the coronary sinus orifice (left atrial free wall), indicating atypical AVNRT.

Experimental study of the effects of multi-site sequential ventricular pacing on the prophylaxis of ventricular fibrillation.

Previous studies report a significant prophylactic effect on the occurrence of atrial fibrillation by simultaneous multi-site atrial pacing. We investigated the effects of multi-site sequential ventricular pacing (MSVP), which may be preferable to simultaneous multi-site pacing in terms of the prophylaxis of the occurrence of ventricular fibrillation (VF). Needle electrodes were inserted at ten different epicardial sites on both ventricles for MSVP in 12 adult beagle dogs.