title: A new electrophysiologic observation in patients with idiopathic left ventricular tachycardia.
abstract: In patients with idiopathic left ventricular tachycardia (ILVT), the arrhythmogenic substrate is poorly understood.
  
  
  
  The purpose of this study was to elucidate the ILVT characteristics and outcome of radiofrequency catheter ablation in patients with ILVT.
  
  
  
  Twenty-four patients with ILVT and 15 patients with left accessory pathways (control) underwent high-density mapping of the left His-Purkinje system during sinus rhythm (SR) using 3-dimensional electroanatomic mapping.
  
  
  
  Fragmented antegrade Purkinje potential (FAP) was represented at the left ventricular septum slightly inferoposterior to the left posterior fascicle (LPF) in 23 patients with ILVT. In control subjects, no FAPs could be recorded at the same region, FAPs were identified at the proximal portion of the LPF (4 patients) and at the distal LPF (1 patient). The finding of any FAPs in ILVT patients was significantly higher than that in control patients (23/24 vs 5/15, P < .01). Radiofrequency ablation at the area of FAP resulted in successful ablation in 23 patients with ILVT. No ILVT recurred during follow-up of 16.3 ± 7.2 months.
  
  
  
  In patients with ILVT, FAP located at the left ventricular septum slightly inferoposterior to the LPF is a novel finding using 3-dimensional electroanatomic mapping. The FAP may represent an arrhythmogenic substrate in ILVT and may be used for guiding successful ablation.
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Xian-Zhang
authors.initials: XZ
authors.lastname: Zhan
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Yuan-Hong
authors.initials: YH
authors.lastname: Liang
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Xue
authors.affiliation: The Heart Rhythm Center, The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Michael
authors.initials: M
authors.lastname: Shehata
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Hong-Tao
authors.initials: HT
authors.lastname: Liao
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Xian-Hong
authors.initials: XH
authors.lastname: Fang
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Zi-Li
authors.initials: ZL
authors.lastname: Liao
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Deng
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China.
authors.forename: Fei-Ai
authors.initials: FA
authors.lastname: Meng
authors.affiliation: The Heart Rhythm Center, The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Xun-Zhang
authors.initials: XZ
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Guangdong General Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Science, Guangzhou, China. Electronic address: doctorwushulin@163.com.
authors.forename: Shu-Lin
authors.initials: SL
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011690:Purkinje Fibers; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000379:methods; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology
keywords: Ablation; Electrophysiology; Fragmented antegrade Purkinje potential; Idiopathic left ventricular tachycardia; Three-dimensional electroanatomic mapping