Analysis of posterior mitral annular activation during entrainment and catheter ablation of mitral isthmus ventricular tachycardia using a coronary sinus catheter.
A detailed analysis of the ventricular activation along the posterior aspect of the mitral annulus was made using a multipolar catheter positioned in the coronary sinus in a patient with mitral isthmus ventricular tachycardia (VT) associated with a remote inferior myocardial infarction and prior cryosurgical ablation for the elimination of a different preexisting VT. A change in the timing and sequence of the ventricular activation along the isthmus could be observed during induction of the VT and entrainment pacing. A radiofrequency (RF) current application directed at the posterolateral region of the isthmus successfully eliminated this tachycardia. During the RF delivery, complete conduction block was confirmed by a sudden change in the activation sequence during sinus rhythm.
Hayashi
M
M
Nippon Medical School, Tokyo, Japan. m-h4510@fa2.so-net.ne.jp
Kobayashi
Y
Y
Miyauchi
Y
Y
Morita
N
N
Iwasaki
Y
Y
Yashima
M
M
Atarashi
H
H
Takano
T
T
Nitta
T
T
Tanaka
S
S
D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D003452:Cryosurgery; D006801:Humans; D008297:Male; D008943:Mitral Valve; D009203:Myocardial Infarction / Q000150:complications*; D012086:Reoperation; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*