PMID- 15766825
OWN - NLM
STAT- MEDLINE
DCOM- 20050628
LR  - 20061115
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 45
IP  - 6
DP  - 2005 Mar 15
TI  - Electrocardiographic and electrophysiologic characteristics of ventricular 
      tachycardia originating within the pulmonary artery.
PG  - 887-95
AB  - OBJECTIVES: We investigated the electrocardiographic (ECG) and electrophysiologic 
      characteristics of ventricular tachycardia (VT) originating within the pulmonary 
      artery (PA). BACKGROUND: Radiofrequency catheter ablation (RFCA) is routinely 
      applied to the endocardial surface of the right ventricular outflow tract (RVOT) 
      in patients with idiopathic VT of left bundle branch block morphology. It was 
      recently reported that this arrhythmia may originate within the PA. METHODS: 
      Activation mapping and ECG analysis were performed in 24 patients whose VTs or 
      ventricular premature contractions (VPCs) were successfully ablated within the PA 
      (PA group) and in 48 patients whose VTs or VPCs were successfully ablated from 
      the endocardial surface of the RVOT (RV-end-OT group). RESULTS: R-wave amplitudes 
      on inferior ECG leads, aVL/aVR ratio of Q-wave amplitude, and R/S ratio on lead 
      V(2) were significantly larger in the PA group than in the RV-end-OT group. On 
      intracardiac electrograms, atrial potentials were more frequently recorded in the 
      PA group than in the RV-end-OT group (58% vs. 12%; p < 0.01). The amplitude of 
      local ventricular potentials recorded during sinus rhythm within the PA was 
      significantly lower than that recorded from the RV-end-OT (0.62 +/- 0.56 mV vs. 
      1.55 +/- 0.88 mV; p < 0.01). CONCLUSIONS: Ventricular tachycardia originating 
      within the PA has different electrocardiographic and electrophysiologic 
      characteristics from that originating from the RV-end-OT. When mapping the RVOT 
      area, the catheter may be located within the PA if a low-voltage atrial or local 
      ventricular potential of <1-mV amplitude is recorded. Heightened attention must 
      be paid if RFCA is required within the PA.
FAU - Sekiguchi, Yukio
AU  - Sekiguchi Y
AD  - Cardiovascular Center, Yokosuka Kyosai General Hospital, Kanagawa, Japan. 
      y-seki@dg7.so-net.ne.jp
FAU - Aonuma, Kazutaka
AU  - Aonuma K
FAU - Takahashi, Atsushi
AU  - Takahashi A
FAU - Yamauchi, Yasuteru
AU  - Yamauchi Y
FAU - Hachiya, Hitoshi
AU  - Hachiya H
FAU - Yokoyama, Yasuhiro
AU  - Yokoyama Y
FAU - Iesaka, Yoshito
AU  - Iesaka Y
FAU - Isobe, Mitsuaki
AU  - Isobe M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Adult
MH  - Aged
MH  - Bundle-Branch Block/diagnosis/surgery
MH  - Catheter Ablation
MH  - Coronary Angiography
MH  - Echocardiography
MH  - *Electrocardiography
MH  - *Electrophysiologic Techniques, Cardiac
MH  - Female
MH  - Heart Conduction System/pathology/surgery
MH  - Heart Ventricles/pathology/surgery
MH  - Humans
MH  - Japan
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Artery/*pathology/surgery
MH  - Tachycardia, Ventricular/*diagnosis/surgery
MH  - Treatment Outcome
MH  - Ventricular Outflow Obstruction/diagnosis/surgery
EDAT- 2005/03/16 09:00
MHDA- 2005/06/29 09:00
CRDT- 2005/03/16 09:00
PHST- 2004/09/29 00:00 [received]
PHST- 2004/10/27 00:00 [accepted]
PHST- 2005/03/16 09:00 [pubmed]
PHST- 2005/06/29 09:00 [medline]
PHST- 2005/03/16 09:00 [entrez]
AID - S0735-1097(04)02491-X [pii]
AID - 10.1016/j.jacc.2004.10.071 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2005 Mar 15;45(6):887-95. doi: 10.1016/j.jacc.2004.10.071.