Comparison of presystolic purkinje and late diastolic potentials for selection of ablation site in idiopathic verapamil sensitive left ventricular tachycardia.
BACKGROUND
Idiopathic verapamil-sensitive left ventricular tachycardia (ILVT) is the most common form of idiopathic left ventricular tachycardia (VT). Different methods have been proposed for ablation of ILVT.


METHODS
Between June 2002 and February 2004, 15 patients (12 men; age 28 +/- 11 years, range 12 to 51) with ILVT underwent radiofrequency (RF) ablation at our center. We retrospectively assessed the significance of recording purkinje potential (PP) and late diastolic potential (DP) and its effect on selection of ablation target and number of RF application.


RESULTS
Sixteen VTs were observed. The clinical VT had either RBBB and left axis morphology (14 cases) or RBBB and right axis morphology (2 cases). The QRS duration during tachycardia was 124 +/- 12 ms and the tachycardia cycle length was 356 +/- 53 ms. DP and PP were recorded at the targeted area for RF ablation in 11 and 9 patients respectively. The PP-Q interval, DP-Q interval and DP width were 18 +/- 4, 53 +/- 18 and 14 +/- 8 ms, respectively. The number of RF application was 7.2 +/- 4.3. Fewer applications were needed in whom RF ablation was initially targeted to PP (with or without DP) recording site (10 patients, 4.7 +/- 1.8) compared to those targeted to DP recording site (5 patients, 12.2 +/- 3.3) ( P < 0.05).


CONCLUSIONS
Compared to DP alone, earliest PP (with or without concomitant DP) might be superior for selection of target site of RF ablation in patients with ILVT.
Arya
Arash
A
Department of Pacemaker and Electrophysiology, Rajaie Cardiovascular Medical Center, Mellat Park, Vali Asr Avenue, Tehran 1996911151, Iran. arya@rhc.ac.ir
Haghjoo
Majid
M
Emkanjoo
Zahra
Z
Fazelifar
Amir Farjam
AF
Dehghani
Mohammad Reza
MR
Heydari
Alireza
A
Sadr-Ameli
Mohammad Ali
MA
D000293:Adolescent; D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017115:Catheter Ablation; D002648:Child; D003971:Diastole / Q000502:physiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011690:Purkinje Fibers / Q000503:physiopathology*; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*; D014700:Verapamil / Q000627:therapeutic use
D000889:Anti-Arrhythmia Agents; D014700:Verapamil