The significance of repetitive ventricular responses induced by radiofrequency energy application for idiopathic left ventricular tachycardia.
In radiofrequency (RF) ablation for idiopathic left ventricular tachycardia (ILVT), the termination of tachycardia during RF ablation is considered a hallmark of success. However, in cases of patients with difficulty of induction of ventricular tachycardia (VT), the evaluation of procedural success can be problematic. We have observed thermal responses reflected as ventricular rhythm change to RF energy delivered on sinus rhythm for ILVT. We therefore describe the significance of repetitive ventricular responses. The study subjects were 11 ILVT patients for whom RF energy was delivered during sinus rhythm because of difficulty in re-induction of tachycardia. During each energy delivery, we focused on the occurrence of repetitive ventricular responses especially exhibiting a similar morphology to clinical VT. The repetitive ventricular responses were noted in 10 of 11 patients. Two patients received a second procedure due to the recurrence of ILVT. The mean follow-up period was 36.2+/-12.8 months. The clinical course of the remaining patients was favorable and without recurrence of ILVT. Based on the favorable clinical outcomes, ablation-induced repetitive ventricular responses with similar QRS morphology to clinical ILVT are useful markers for selecting an ablation site and could be used as an additional mapping method, termed as "thermal mapping".
Shin
Woo Seung
WS
Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, School of Medicine, Seoul, Korea.
Lee
Man Young
MY
Jang
Sung Won
SW
Kim
Ji Hoon
JH
Yoon
Hee Jeoung
HJ
Jin
Seung Won
SW
Oh
Yong Seog
YS
Seung
Ki Bae
KB
Rho
Tai Ho
TH
D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation; D004562:Electrocardiography; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000503:physiopathology* / Q000601:surgery*; D016277:Ventricular Function, Left / Q000502:physiology