AI Article Synopsis
- In patients with idiopathic left ventricular tachycardia (ILVT), the causes of arrhythmia are not well understood, prompting this study to explore its characteristics and outcomes from treatment.
- The study involved high-density mapping of the left His-Purkinje system in 24 ILVT patients compared to 15 control patients, revealing a significant occurrence of fragmented antegrade Purkinje potentials (FAPs) in ILVT patients.
- Successful radiofrequency catheter ablation based on the identified FAPs was achieved in 23 of the ILVT patients, and none experienced recurrent ILVT during an average follow-up of over 16 months.
Article Abstract
Background: In patients with idiopathic left ventricular tachycardia (ILVT), the arrhythmogenic substrate is poorly understood.
Objective: The purpose of this study was to elucidate the ILVT characteristics and outcome of radiofrequency catheter ablation in patients with ILVT.
Methods: Twenty-four patients with ILVT and 15 patients with left accessory pathways (control) underwent high-density mapping of the left His-Purkinje system during sinus rhythm (SR) using 3-dimensional electroanatomic mapping.
Results: Fragmented antegrade Purkinje potential (FAP) was represented at the left ventricular septum slightly inferoposterior to the left posterior fascicle (LPF) in 23 patients with ILVT. In control subjects, no FAPs could be recorded at the same region, FAPs were identified at the proximal portion of the LPF (4 patients) and at the distal LPF (1 patient). The finding of any FAPs in ILVT patients was significantly higher than that in control patients (23/24 vs 5/15, P < .01). Radiofrequency ablation at the area of FAP resulted in successful ablation in 23 patients with ILVT. No ILVT recurred during follow-up of 16.3 ± 7.2 months.
Conclusion: In patients with ILVT, FAP located at the left ventricular septum slightly inferoposterior to the LPF is a novel finding using 3-dimensional electroanatomic mapping. The FAP may represent an arrhythmogenic substrate in ILVT and may be used for guiding successful ablation.
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| http://dx.doi.org/10.1016/j.hrthm.2016.03.007 | DOI Listing |
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