Irregular ventricular tachycardia: A possible manifestation of longitudinal dissociation within the reentry pathway

Oreto, Giuseppe; Satullo, Gaetano; Luzza, Francesco; Donato, Antonino; Scimone, Ignazio M.; Cavalli, A

doi:10.1016/0002-8703(92)90064-3

Cited by 9 publications

(2 citation statements)

References 12 publications

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“…In reentrant VTs, alterations in QRS morphology may be observed in some patients, reflecting multiple slow pathways, multiple exits, or different patterns of activation in the myocardium distal to the exit as possible underlying mechanisms 17–19 . However, in the present study, neither the first nor second OTVTs could be induced by programmed electrical stimulation; instead, they occurred spontaneously or during isoproterenol infusion.…”

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confidence: 57%

Prevalence and Characteristics of Idiopathic Outflow Tract Tachycardia with QRS Alteration Following Catheter Ablation Requiring Additional Radiofrequency Ablation at a Different Point in the Outflow Tract

Tada

Hiratsuji

Naito

et al. 2004

Pacing Clinical Electrophis

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Subtle variations in QRS morphology occurs during idiopathic outflow tract ventricular tachycardia (OTVT), but no studies have clarified the prevalence and characteristics of the OTVT with altered QRS morphology following radiofrequency catheter ablation (RFA), which then require an additional RF application at a different portion of the outflow tract to abolish OTVT. Of 202 patients with a monomorphic VT or premature ventricular contraction (PVC) originating from the outflow tract, 6 (3%) showed changes in QRS morphology in the OTVT following RFA, requiring an additional RF application to the outflow tract at a different portion. In all six patients, RFA was applied for the first or second OTVT to a right or left ventricular endocardial site, with the other site being the left sinus of Valsalva. In each patient, OTVT before or after the changes in QRS morphology had characteristic ECG findings originating from a particular portion of the outflow tract. Changes in QRS morphology consistently included an increase or decrease in R wave amplitude in all inferior leads. Detailed continuous observation of QRS morphology in OTVT, especially R wave amplitude in inferior leads, is important for identifying changes of QRS morphology during catheter ablation. Mapping and ablation at a different portion of the outflow tract is then needed for cure.

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