Electrophysiologic characterization of local abnormal ventricular activities in postinfarction ventricular tachycardia with respect to their anatomic location.

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State: Public
Version: Final published version
Serval ID
serval:BIB_15AC37ADA37B
Type
Article: article from journal or magazin.
Collection
Publications
Title
Electrophysiologic characterization of local abnormal ventricular activities in postinfarction ventricular tachycardia with respect to their anatomic location.
Journal
Heart Rhythm
Author(s)
Komatsu Y., Daly M., Sacher F., Derval N., Pascale P., Roten L., Scherr D., Jadidi A., Ramoul K., Denis A., Jesel L., Zellerhoff S., Lim H.S., Shah A., Cochet H., Hocini M., Haïssaguerre M., Jaïs P.
ISSN
1556-3871 (Electronic)
ISSN-L
1547-5271
Publication state
Published
Issued date
2013
Volume
10
Number
11
Pages
1630-1637
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
BACKGROUND: Local abnormal ventricular activities (LAVA) in patients with scar-related ventricular tachycardia (VT) may appear at any time during or after the far-field electrogram. Although they may be separated from the far-field signal by an isoelectric line and extend beyond the end of surface QRS, they may also appear fused or buried within the QRS.
OBJECTIVE: The purpose of this study was to characterize LAVA in postinfarction VT patients with respect to their anatomic locations.
METHODS: Thirty-one patients with postinfarction VT underwent mapping/ablation during sinus rhythm with a three-dimensional electroanatomic mapping system. From a total of 18,270 electrograms reviewed in all study subjects, 1104 LAVA (endocardium 839, epicardium 265) were identified and analyzed.
RESULTS: The interval from onset of QRS complex to ventricular electrogram (EGM onset) on the endocardium was significantly shorter than the epicardium (P < .001). EGM onset was shortest in the septal endocardium and longest in the inferior and lateral epicardium. There was a significant positive correlation between EGM onset and LAVA lateness as estimated by the interval from surface QRS onset to LAVA (r = 0.52, P < .001). LAVA were more frequently detected after the QRS complex in the epicardium (241/265 [91%]) than in the endocardium (551/839 [66%], P < .001). Only 43% of endocardial septal LAVA were detected after the QRS complex.
CONCLUSION: Lateness of LAVA is affected to a large extent by their locations. The chance of detecting late LAVA increases when electrogram onset is later. Substrate-based approach targeting delayed signals relative to the QRS complex may miss critical the arrhythmogenic substrate, particularly in the septum and other early-to-activate regions.
Keywords
Body Surface Potential Mapping/methods, Catheter Ablation, Endocardium/physiopathology, Female, Follow-Up Studies, Heart Conduction System/physiopathology, Heart Conduction System/surgery, Heart Ventricles/physiopathology, Humans, Imaging, Three-Dimensional, Male, Middle Aged, Myocardial Infarction/complications, Myocardial Infarction/physiopathology, Retrospective Studies, Tachycardia, Ventricular/etiology, Tachycardia, Ventricular/physiopathology
Pubmed
Web of science
Create date
15/07/2014 10:28
Last modification date
20/08/2019 12:44
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