Sustained ventricular tachycardia: role of the 12-lead electrocardiogram in localizing site of origin.

Abstract

SUMMARY The QRS morphology of the 12-lead ECG of 41 morphologically distinct ventricular tachycardias (VT) was correlated with their site of origin as determined by catheter and intraoperative mapping. Twenty-two VT patterns had a right bundle branch block (VT-RBBB) morphology

Relationship between the 12-lead electrocardiogram during ventricular tachycardia and endocardial site of origin in patients with coronary artery disease.

“…Currently, the most reliable method for acquiring information concerning the location(s) of arrhythmogenic areas is activation mapping of the heart during VT6; prior studies have shown that eradication of endocardial tissue from which presystolic electrical activity during VT is recorded can result in cure of VT.3' 7 Detailed activation mapping during VT is not always possible due to hemodynamic intolerance of VT or changes in QRS morphology of VT.8 Alternative methods for obtaining information regarding "sites of origin" of VT have been applied, including pacemapping9 and noninvasive means of detecting areas of earliest wall motion (gated nuclear scans, echocardiography).1O 13 A previous study from this laboratory correlated features of the 12-lead ECG during VT with sites of endocardial origin in a small number of patients. 14 The current study expands on this experience with the use of the 12-lead electrocardiogram (ECG) during VT as a guide to the location of VT sites of origin. The study consisted of (1) correlation of features of the 12-lead ECG of VT with activation mapping data in one group of patients, (2) formulation of an algorithm comprising these correlative features, and (3) prospective application of this algorithm in a second group of patients.…”

An algorithm for topical electrocardiographic diagnosis of ventricular arrhythmias in children

“…Так, для правожелудочковых аритмий характерна морфология блокады левой ножки пучка Гиса, а для левожелудочковых локализаций -мор-фология блокады правой ножки пучка Гиса. С вне-дрением метода эндокардиального картирования появилась возможность провести детальный ЭКГ-анализ топики желудочковых аритмий на основании сопоставления поверхностной ЭКГ и данных внутри-сердечного инвазивного электрофизиологического исследования [14].…”

Mark E Josephson: A Tribute to His Work on Ventricular Arrhythmias

“…6 The paper had 11 figures, each with multiple 12-lead ECGs, helping the reader understand how the 12-lead ECG QRS pattern could help regionalise the area of interest to focus more detailed mapping.…”