The morphology changes in limb leads after ablation of verapamil-sensitive idiopathic left ventricular tachycardia and their correlation with recurrence.
OBJECTIVE
This study was designed to explore the morphology changes in limb leads of ECGs after successful ablation of verapamil sensitive idiopathic left ventricular tachycardia (ILVT) and their correlation with tachycardia recurrence.


METHODS
Between January 2001 and December 2006, 116 patients who underwent successful ablation of ILVT were included in the study. Twelve-lead surface ECG recordings during sinus rhythm were obtained in all patients before and after ablation to compare morphology changes in limb leads.


RESULTS
The ECG morphology changes after ablation were divided into two categories: one with new or deepening Q wave in inferior leads and/or disappearance of Q wave in leads I and aVL, and the other without change. The changes in any Lead II, III, or aVF after ablation occurred significantly more in patients without recurrence of ventricular tachycardia (VT) (P < 0.0001, 0.002, and 0.0001, respectively). The patients with recurrence of VT tended to have no ECG changes, compared with those without recurrence of VT (P = 0.009). The sensitivity of leads II, III, and aVF changes in predicting nonrecurrence VT were 66.7%, 78.7%, and 79.6%, specificity were 100%, 75%, and 87.5%, and nonrecurrence predictive value of 100%, 97.7%, and 98.9%, respectively. When inferior leads changes were combined, they could predict all nonrecurrence patients with 100% specificity.


CONCLUSIONS
Successful radiofrequency ablation of ILVT could result in morphology changes in limb leads of ECG, especially in inferior leads. The combined changes in inferior leads can be used as an effective endpoint in ablation of this ILVT.
Yao
Shu-Yuan
SY
Center of Arrhythmia, Fuwai Cardiovascular Hospital, Peking Union Medical College, Beijing.
Chu
Jian-Min
JM
Fang
Pi-Hua
PH
Zhang
Kui-Jun
KJ
Ma
Jian
J
Zhang
Shu
S
D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055502:Secondary Prevention; D013223:Statistics as Topic; D017180:Tachycardia, Ventricular / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome; D014665:Vasodilator Agents; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D014700:Verapamil
D014665:Vasodilator Agents; D014700:Verapamil