Idiopathic left ventricular tachycardia with block between purkinje potential and ventricular myocardium.
We performed radiofrequency current catheter ablation in a patient with idiopathic LV. While mapping the inferoapical LV septum during tachycardia, spontaneous termination of tachycardia was observed with block between Purkinje (P) potential and ventricular electrogram (P-V block). The cycle length of the tachycardia was associated with prolongation of P-P interval and P-V interval. P potential recording at this site was earliest and at very low amplitude during tachycardia. The radiofrequency current at this site was successful. These findings indicated that Purkinje fiber was a critical part of the tachycardia circuit. Ablation was successful at a site where both an earliest and low amplitude P potential was recorded during tachycardia, and where P-V block that was induced by catheter manipulation was observed during tachycardia.
Tomokuni
A
A
First Department of Internal Medicine, Tottori University School of Medicine, Japan.
Igawa
O
O
Yamanouchi
Y
Y
Adachi
M
M
Suga
T
T
Yano
A
A
Miake
J
J
Inoue
Y
Y
Fujita
S
S
Hisatome
I
I
Shigemasa
C
C
D000328:Adult; D017115:Catheter Ablation; D004562:Electrocardiography; D006352:Heart Ventricles / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D011690:Purkinje Fibers / Q000503:physiopathology* / Q000601:surgery; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D016277:Ventricular Function, Left / Q000502:physiology