Identification of Unusual Reentry Circuit Sites of Nonischemic Ventricular Outflow Tract Tachycardia

Nakano, Emi; Harada, Tomoo; Aonuma, Kazutaka; Soejima, Kyoko; Wakimoto, Hirofumi; Matsumoto, Naoki; Miyake, Fumihiko

doi:10.1111/j.1540-8167.2011.02149.x

Cited by 5 publications

(3 citation statements)

References 26 publications

(39 reference statements)

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“…While idiopathic VT originating from the LV outflow tract is mainly caused by focal mechanisms, i.e., triggered activity or abnormal automaticity, re-entrant VT arises in a J o u r n a l P r e -p r o o f 10 structurally abnormal heart due to the presence of scar tissue. 8,9 This case is extremely valuable because the patient had idiopathic re-entrant VT with a three-dimensional tachycardia circuit with a diastolic pathway in the AMC despite showing good cardiac function without any abnormalities in echocardiography and the absence of LGE in the right and left ventricles including the outflow tract.…”

Section: Discussionmentioning

confidence: 99%

Utility of the novel microcatheter in left ventricular summit arrhythmias with a tortuous anterior interventricular vein

Sagawa

Yamauchi

Ohgino

et al. 2022

HeartRhythm Case Reports

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Section: Discussionmentioning

confidence: 99%

Utility of the novel microcatheter in left ventricular summit arrhythmias with a tortuous anterior interventricular vein

Sagawa

Yamauchi

Ohgino

et al. 2022

HeartRhythm Case Reports

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“…However, re-entrant mechanisms have also been implicated. Nakano et al performed electrophysiological testing on 51 consecutive patients referred for evaluation of idiopathic outflow tract ventricular tachycardia [5]. Six patients were determined to have VT of re-entrant mechanism via entrainment mapping.…”

Section: Discussionmentioning

confidence: 99%

Aortic Sinus of Valsalva Aneurysm Isolation by Radiofrequency Ablation in Outflow Tract Ventricular Tachycardia

Olson¹,

Ferreira²,

Mikolajczak³

et al. 2014

WJCD

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Idiopathic monomorphic ventricular tachycardia and premature ventricular complexes (PVCs) commonly arise from the right and left ventricular outflow tracts (VOT). Their mechanism is most commonly triggered activity from delayed after-depolarizations and successful ablation is performed at the site of earliest endocardial activation. Re-entrant mechanisms have been rarely described. We report a case of an otherwise healthy patient who ultimately underwent six electrophysiology studies (EPS) and suffered numerous implantable cardiac defibrillator (ICD) discharges prior to the successful radiofrequency ablation (RFA) of two idiopathic VOT tachycardias. During the sixth EPS, a proximal aortogram demonstrated a left aortic sinus of valsalva (LASV) aneurysm. Subsequntly, a novel and successful RFA strategy of aneurysm isolation was undertaken. The presence of multiple clinical or inducible VT morphologies and the characterization of a VT as re-entrant should raise concerns that a complex arrhythmogenic substrate is present and defining the anatomy with angiography or an alternative imaging modality is essential in achieving a successful ablation strategy.

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“…The measurement of the PPI at different pacing sites used along with other electrocardiographic observations (see below) was termed entrainment mapping, and was proposed as a way to localize VT circuits and guide catheter ablation . Over the last two decades this methodology has been extended and explored in almost every single type of atrial and ventricular arrhythmia presumed to be reentrant . In many studies it has been integrated with nonfluoroscopic navigation systems.…”

Section: An Analysis Of the Ppi Or Return Cycle To Localize Reentrymentioning

confidence: 99%

Resetting and Entrainment of Reentrant Arrhythmias: Part II: Informative Content and Practical Use of These Responses

Almendral

2013

Pacing Clinical Electrophis

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This paper is the second part of a review of the phenomena of resetting and entrainment of reentrant arrhythmias. It describes the practical and clinical uses of resetting and entrainment, including the results of a variety of studies for these purposes. Given the amount of information generated, it is out of the scope of this review to comment in detail about each of the published studies. We rather present the basis for each described clinical use and for each type of arrhythmia in which these phenomena have been used with illustrative examples. The review covers: resetting response patterns; resetting/entrainment and termination; resetting/entrainment, fusion, and reentry; analysis of the postpacing interval; concealed entrainment; resetting/entrainment as an aid in the differential diagnosis among different arrhythmic mechanisms; usefulness of these phenomena in arrhythmic mechanisms other than macrorreentry. Finally, we make some comments about the recent use of these phenomena and propose two new criteria for entrainment recognition.

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Identification of Unusual Reentry Circuit Sites of Nonischemic Ventricular Outflow Tract Tachycardia

Abstract: We definitively demonstrated involvement of the ASOV in OT reentrant tachycardia using entrainment mapping. It may be useful for successful VT ablation to identify reentry circuit localization.

Cited by 5 publications

References 26 publications

Utility of the novel microcatheter in left ventricular summit arrhythmias with a tortuous anterior interventricular vein

Utility of the novel microcatheter in left ventricular summit arrhythmias with a tortuous anterior interventricular vein

Aortic Sinus of Valsalva Aneurysm Isolation by Radiofrequency Ablation in Outflow Tract Ventricular Tachycardia

Resetting and Entrainment of Reentrant Arrhythmias: Part II: Informative Content and Practical Use of These Responses

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