Details

Autor(en) / Beteiligte

• PEETERS, H. A. P
• SIPPENSGROENEWEGEN, A
• WEVER, E. F. D
• RAMANNA, H
• LINNENBANK, A. C
• POTSE, M
• GRIMBERGEN, C. A
• VAN HEMEL, N. M
• HAUER, R. N. W
• DE MEDINA, E. O. R

Titel

Clinical application of an integrated 3-phase mapping technique for localization of the site of origin of idiopathic ventricular tachycardia

Ist Teil von

• Circulation (New York, N.Y.), 1999-03, Vol.99 (10), p.1300-1311

Ort / Verlag

Hagerstown, MD: Lippincott Williams & Wilkins

Erscheinungsjahr

1999

Quelle

MEDLINE

Beschreibungen/Notizen

• Radiofrequency (RF) catheter ablation provides curative treatment for idiopathic ventricular tachycardia (VT). Nineteen consecutive patients with an idiopathic VT underwent RF catheter ablation. An integrated 3-phase mapping approach was used, consisting of the successive application of online 62-lead body surface QRS integral mapping, directed regional paced body surface QRS integral mapping, and local activation sequence mapping. Mapping phase 1 was localization of the segment of VT origin by comparing the VT QRS integral map with a database of mean paced QRS integral maps. Mapping phase 2 was body surface pace mapping during sinus rhythm in the segment localized in phase 1 until the site at which the paced QRS integral map matched the VT QRS integral map was identified (ie, VT exit site). Mapping phase 3 was local activation sequence mapping at the circumscribed area identified in phase 2 to identify the site with the earliest local endocardial activation (ie, site of VT origin). This site became the ablation target. Ten VTs were ablated in the right ventricular outflow tract, 2 at the basal LV septum, and 7 at the midapical posterior left ventricle. A high long-term ablation success (mean follow-up duration, 14+/-9 months) was achieved in 17 of the 19 patients (89%) with a low number of RF pulses (mean, 3.3+/-2.2 pulses per patient). This prospective study shows that integrated 3-phase mapping for localization of the site of origin of idiopathic VT offers efficient and accurate localization of the target site for RF catheter ablation.