Electronic Resource
YAMAUCHI, YASUTERU
;
AONUMA, KAZUTAKA
;
TAKAHASHI, ATSUSHI
;
[et al.]
SEKIGUCHI, YUKIO
;
HACHIYA, HITOSHI
;
YOKOYAMA, YASUHIRO
;
KUMAGAI, KOJI
;
NOGAMI, AKIHIKO
;
IESAKA, YOSHITO
;
ISOBE, MITSUAKI
350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK .
:
Blackwell Science Inc
Journal of cardiovascular electrophysiology
16 (2005), S. 0
ISSN:
1540-8167
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Introduction: Most idiopathic nonreentrant ventricular tachycardia (VT) and ventricular premature contractions (VPCs) arise from the right or left ventricular outflow tract (OT). However, some right ventricular (RV) VT/VPCs originate near the His-bundle region. The aim of this study was to investigate ECG characteristics of VT/VPCs originating near the His-bundle in comparison with right ventricular outflow tract (RVOT)-VT/VPCs. Methods and Results: Ninety RV-VT/VPC patients underwent catheter mapping and radiofrequency ablation. ECG variables were compared between VT/VPCs originating from the RVOT and near the His-bundle. Ten patients had foci near the His-bundle (HIS group), with the His-bundle local ventricular electrogram preceding the QRS onset by 15–35 msec (mean: 22 msec) and His-bundle pacing produced a nearly identical ECG to clinical VT/VPCs. The HIS group R wave amplitude in the inferior leads (lead III: 1.0 ± 0.6 mV) was significantly lower than that of the RVOT group (1.7 ± 0.4 mV, P 〈 0.05). An R wave in aVL was present in 6 of 10 HIS group patients, while almost all RVOT group patients had a QS pattern in aVL. Lead I in HIS group exhibited significantly taller R wave amplitudes than RVOT group. HIS group QRS duration in the inferior leads was shorter than that of the RVOT group. Eight of 10 HIS group patients exhibited a QS pattern in lead V1 compared to 14 of 81 RVOT group patients. HIS group had larger R wave amplitudes in leads V5 and V6 than RVOT group. Conclusion: VT/VPCs originating near the His-bundle have distinctive ECG characteristics. Knowledge of the characteristic QRS morphology may facilitate catheter mapping and successful ablation.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1540-8167.2005.40787.x
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