title: Radiofrequency catheter ablation of ventricular tachycardia originating in the left posterior and left anterior fascicles in a patient with prior myocardial infarction.
abstract: A 61-year-old man with prior anteroseptal myocardial infarction (ejection fraction: 40%) presented with recurrent episodes of palpitations. Twelve-lead ECG during palpitations showed an incessant ventricular tachycardia (VT1) with right bundle branch block (RBBB) morphology and inferior axis. Electrophysiologic study revealed that the clinical VT originated from the anterolateral left ventricle. A Purkinje potential preceded onset of the QRS complex by 34 ms. Radiofrequency ablation guided by the Purkinje potential terminated the VT1. Another ventricular tachycardia (VT2) showing RBBB morphology with superior axis and originating from the posteroseptal left ventricle, was induced by programmed ventricular stimulation. A Purkinje potential preceded onset of the local ventricular potential by 120-130 ms in this VT. Radiofrequency ablation guided by the Purkinje potential terminated the VT2.
authors: Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors: Sonoko
authors: S
authors: Ashino
authors: Ichiro
authors: I
authors: Watanabe
authors: Masayoshi
authors: M
authors: Kofune
authors: Yasuo
authors: Y
authors: Okumura
authors: Kazunori
authors: K
authors: Kawauchi
authors: Takeshi
authors: T
authors: Yamada
authors: Kimie
authors: K
authors: Okubo
authors: Kenichi
authors: K
authors: Hashimoto
authors: Atsushi
authors: A
authors: Shindo
authors: Hidezou
authors: H
authors: Sugimura
authors: Toshiko
authors: T
authors: Nakai
authors: Satoshi
authors: S
authors: Saito
authors: Atsushi
authors: A
authors: Hirayama
mesh_terms: D002037:Bundle-Branch Block / Q000150:complications; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011690:Purkinje Fibers / Q000503:physiopathology; D017180:Tachycardia, Ventricular / Q000601:surgery*