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Reentrant Ventricular Tachycardia Originating from the Aortic Sinus Cusp:
Author(s) -
TSUCHIYA TAKESHI,
YAMAMOTO KUNIHIKO,
TANAKA ERIKO,
TASHIRO HIDEKI
Publication year - 2004
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2004.03695.x
Subject(s) - medicine , cardiology , reentry , tachycardia , cusp (singularity) , aortic sinus , qrs complex , entrainment (biomusicology) , ventricular outflow tract , ablation , atrioventricular reentrant tachycardia , coronary sinus , ventricular tachycardia , catheter ablation , accessory pathway , aorta , geometry , mathematics , rhythm
We report a case of idiopathic reentrant ventricular tachycardia (VT) originating from the left aortic sinus cusp. A prepotential preceding the QRS complex by 58 ms was recorded from the posterior right ventricular (RV) outflow tract. During VT entrainment observed by pacing from the midseptal RV, it initially was orthodromically captured with a long conduction time but then antidromically captured as the pacing cycle rate was increased. Pacing at that site failed to show concealed entrainment despite a postpacing interval similar to the VT cycle length. Radiofrequency catheter ablation abolished the VT in the left aortic sinus cusp where a prepotential preceding the QRS complex by 78 ms with a postpacing interval similar to the VT cycle length was recorded in addition to concealed entrainment. The findings suggest that, in this VT, a critical slow conduction zone is partially present extending from the left aortic sinus cusp to the posterior right ventricular outflow tract. The patient has remained free from VT recurrence after 5‐month follow‐up.