Electrocardiographic pattern as a guide for management and radiofrequency ablation of idiopathic ventricular tachycardia.

Tanner, Hildegard; Wolber, Thomas; Schwick, Nicola; Fuhrer, Juerg; Delacretaz, Etienne (2005). Electrocardiographic pattern as a guide for management and radiofrequency ablation of idiopathic ventricular tachycardia. Cardiology, 103(1), pp. 30-36. Karger 10.1159/000081849

Full text not available from this repository. (Request a copy)

BACKGROUND Idiopathic ventricular tachycardia (VT) often originates from the right ventricular outflow tract (RVOT), but foci deep to the endocardium, in the epicardium, or in the left ventricle are not uncommon. Although these extra-RVOT foci can be targeted with ablation, risks involved are higher and success rates lower. Simple electrocardiographic (ECG) criteria allowing (1) discrimination of RVOT foci from extra-RVOT foci and (2) assessment of the chance of success of a right heart ablation procedure are desirable. METHODS Twenty-five consecutive patients referred for radiofrequency (RF) ablation of idiopathic VT or severely symptomatic idiopathic ventricular premature contractions were included. Localization of VT origin and success rates of VT ablation in the RVOT were analyzed according to the ECG pattern. RESULTS The analysis of the R wave in V2 was the strongest single predictor of whether the VT had an RVOT or an extra-RVOT origin. An R wave amplitude < or =30% of the QRS amplitude designated the VT focus in the RVOT with positive and negative predictive values of 95 and 100%, respectively. Analysis of R wave duration in V2 had similar predictive values, whereas the R/S transition zone in precordial leads had slightly lower predictive values. Seventeen of 20 arrhythmias (85%) with an R wave amplitude < or =30% of the QRS amplitude in V2 could be successfully abolished by an exclusively right heart procedure. CONCLUSIONS The analysis of ECG pattern makes it possible to guide the management of patients with idiopathic VT in predicting the arrhythmias that can be safely targeted with RF ablation from the RVOT with high success rates.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Tanner, Hildegard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0008-6312

Publisher:

Karger

Language:

English

Submitter:

Hildegard Tanner

Date Deposited:

03 Jul 2014 14:56

Last Modified:

03 Jul 2014 14:56

Publisher DOI:

10.1159/000081849

PubMed ID:

15528898

URI:

https://boris.unibe.ch/id/eprint/42314

Actions (login required)

Edit item Edit item
Provide Feedback