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Catheter Ablation of Idiopathic Left Anterior Fascicular Ventricular Arrhythmias: Predicting Origin Sites via Mapping and Electrocardiography.
J Cardiovasc Electrophysiol
December 2024
Department of Cardiology, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Background: Idiopathic ventricular arrhythmias (VAs) arising from the left anterior fascicle (LAF) are uncommonly seen, and their characteristics still need to be sufficiently investigated. This study aimed to conclude these VAs' characteristics and explore efficient ablation strategies.
Methods: Data were analyzed from 118 patients undergoing successful catheter ablation for LAF VAs.
Atypical Wenckebach AV Block in the Infra-Hisian Region: Clinical Implications and Management.
Am J Case Rep
December 2024
Department of Cardiac Pacing and Electrophysiology, Fortis Escorts Heart Institute (FEHI), New Delhi, India.
BACKGROUND Second-degree atrioventricular (AV) block is a frequently encountered conduction abnormality on surface electrocardiogram (ECG). However, it does not always imply a block at the AV nodal level. In rare cases, this block can occur below the bundle of His, within the infra-Hisian region of the His-Purkinje system.
View Article and Find Full Text PDFApproach to the Diagnosis and Management of Complex Fascicular Ventricular Tachycardias.
Circ Arrhythm Electrophysiol
December 2024
Division of Cardiology, University of California San Francisco (H.H.H., A.C.L., M.M.S.).
Complex ventricular tachycardias involving the fascicular system (fascicular ventricular tachycardias [FVTs]) can be challenging. In this review, we describe our approach to the diagnosis and ablation of these arrhythmias with 10 illustrative cases that involve (1) differentiation from supraventricular tachycardia; (2) assessment for atypical bundle branch reentry and other interfascicular FVTs; (3) examination of P1/P2 activation sequences in sinus rhythm, pacing, and tachycardia; and (4) entrainment techniques to establish the tachycardia mechanism and aid circuit localization. To summarize, 5 cases had prior ablation with 2 previously misdiagnosed as supraventricular tachycardia.
View Article and Find Full Text PDFThe pacing maneuvers for supraventricular tachycardia with cycle length alternans are sometimes difficult, especially when diagnostic ventricular pacing does not conduct to the atrium. Even in such a situation, critical diagnostic findings can be obtained by spontaneous premature ventricular contraction.
View Article and Find Full Text PDFA narrow complex tachycardia with a short HV interval: What is the mechanism?
Pacing Clin Electrophysiol
January 2025
Division of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
The case was a 15-year-old male with a history of paroxysmal supraventricular tachycardia refractory to medical therapy and prior catheter. A repeat electrophysiology study and catheter ablation were applied. Baseline AH and HV intervals were 100 and 55 ms during normal sinus rhythm (NSR), respectively.
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