Successful radiofrequency catheter ablation of incessant ventricular tachycardia with a delta wave-like beginning of the QRS complex.
Ventricular tachycardia with a delta wave-like beginning of the QRS complex is considered to be refractory to endocardial catheter ablation because it originates from the epicardial region. A 45-year-old woman had incessant ventricular tachycardia with a delta wave-like beginning of the QRS complex which was resistant to several antiarrhythmic drugs. The origin of the arrhythmia was at the mitral annulus on the antero-lateral left ventricular wall. The earliest endocardial activation preceded the QRS complex by 18 msec. After 7 sec of endocardial radiofrequency application ventricular tachycardia was terminated. During a 2 year follow-up ventricular tachycardia did not recur and only small numbers of premature ventricular contractions (< 100/day) were noted. VT with delta wave-like QRS morphology which originates from the basal region of the ventricle may be treated successfully with radiofrequency catheter ablation using an endocardial approach.
Nagasawa
H
H
Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
Fujiki
A
A
Usui
M
M
Mizumaki
K
K
Hayashi
H
H
Inoue
H
H
D017115:Catheter Ablation; D003700:Delta Rhythm; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology