title: [Ablation of idiopathic fascicular ventricular tachycardia].
abstract: Idiopathic fascicular ventricular tachycardia is an important and not very rare cardiac arrhythmia with specific electrocardiographic features and therapeutic options. Ventricular tachycardia is characterized by relatively narrow QRS complex and right bundle branch block pattern. The QRS axis depends on which fascicle is involved in the re-entry. Left axis deviation is noted with left posterior fascicular tachycardia and right axis deviation with left anterior fascicular tachycardia. A left septal fascicular tachycardia with normal QRS axis is also possible. Idiopathic fascicular tachycardia is usually seen in individuals without structural heart disease. Response to verapamil is an important feature of fascicular tachycardia. In some cases intravenous adenosine may also terminate the arrhythmia. During electrophysiology study, presystolic or diastolic potentials precede the QRS, presumed to originate from the Purkinje fibers. The potentials can be recorded during sinus rhythm and ventricular tachycardia in many patients with fascicular tachycardia. This potential (so-called Purkinje potential) has been used as a guide to catheter ablation. Correct diagnosis of fascicular tachycardia is very important because catheter ablation is very effective in the treatment of this type of ventricular tachycardia. In this review, we describe three patients with idiopathic ventricular tachycardia and their successful catheter ablation, and summarize the actual knowledge of the diagnosis and management of this special ventricular tachycardia.
authors.affiliation: Semmelweis Egyetem, Altalános Orvostudományi Kar, Kardiológiai Központ, Budapest. laszlo.geller@gmail.com
authors.forename: László
authors.initials: L
authors.lastname: Gellér
authors.forename: Szabolcs
authors.initials: S
authors.lastname: Szilágyi
authors.forename: Katalin
authors.initials: K
authors.lastname: Solymossy
authors.forename: Marianna
authors.initials: M
authors.lastname: Srej
authors.forename: Endre
authors.initials: E
authors.lastname: Zima
authors.forename: Tamás
authors.initials: T
authors.lastname: Tahin
authors.forename: Béla
authors.initials: B
authors.lastname: Merkely
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery*; D055815:Young Adult
chemical_list: D000889:Anti-Arrhythmia Agents