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Significance of Two Potentials for Predicting Successful Catheter Ablation From the Left Sinus of Valsalva for Left Ventricular Epicardial Tachycardia
Author(s) -
TADA HIROSHI,
NAITO SHIGETO,
ITO SACHIKO,
KUROSAKI KENJI,
UEDA MAREHIKO,
SHINBO GORO,
HOSHIZAKI HIROSHI,
OSHIMA SHIGERU,
TANIGUCHI KOICHI,
NOGAMI AKIHIKO
Publication year - 2004
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2004.00584.x
Subject(s) - medicine , ablation , cardiology , catheter ablation , aortic sinus , ventricular tachycardia , sinus rhythm , qrs complex , sinus (botany) , tachycardia , aorta , atrial fibrillation , botany , biology , genus
The aim of this study was to identify the characteristics of electrograms that may be helpful in predicting successful ablation of idiopathic ventricular tachycardia from the aortic sinus of Valsalva. Data were obtained from 23 patients with symptomatic ventricular tachycardia or premature ventricular contractions (LV‐VT) who underwent RF catheter ablation from the left sinus of Valsalva. Electrograms before and after application of RF energy during sinus rhythm and during LV‐VT were analyzed. Complete elimination of LV‐VT was finally achieved in 21 (91%) patients. The incidence of presystolic potentials preceding the QRS complex of LV‐VT (P1 potential) was 90% for the 21 successful ablation sites, which did not differ from the incidence for the 24 unsuccessful sites (79%; P = 0.5). During sinus rhythm, a potential following the QRS complex (P2 potential) was more often recorded at the successful ablation site than at an unsuccessful ablation site before and after application of RF energy (before, P < 0.05; after, P < 0.001). The appearance of the P2 potential or a delay in the preexisting P2 potential after application of RF energy was observed only at the successful ablation sites (P < 0.001). In 18 control individuals who had no LV‐VT, no P2 potential was recorded within the left sinus of Valsalva. Although the P1 potential may be useful for identifying the successful ablation site, its sensitivity is low. The appearance of the P2 potential or an increasingly delayed P2 potential after application of RF energy may be more useful than the P1 potential for predicting successful ablation.