PMID- 16191113
OWN - NLM
STAT- MEDLINE
DCOM- 20060120
LR  - 20220408
IS  - 1045-3873 (Print)
IS  - 1045-3873 (Linking)
VI  - 16
IP  - 10
DP  - 2005 Oct
TI  - Electrocardiographic characteristics of repetitive monomorphic right ventricular 
      tachycardia originating near the His-bundle.
PG  - 1041-8
AB  - INTRODUCTION: Most idiopathic nonreentrant ventricular tachycardia (VT) and 
      ventricular premature contractions (VPCs) arise from the right or left 
      ventricular outflow tract (OT). However, some right ventricular (RV) VT/VPCs 
      originate near the His-bundle region. The aim of this study was to investigate 
      ECG characteristics of VT/VPCs originating near the His-bundle in comparison with 
      right ventricular outflow tract (RVOT)-VT/VPCs. METHODS AND RESULTS: Ninety 
      RV-VT/VPC patients underwent catheter mapping and radiofrequency ablation. ECG 
      variables were compared between VT/VPCs originating from the RVOT and near the 
      His-bundle. Ten patients had foci near the His-bundle (HIS group), with the 
      His-bundle local ventricular electrogram preceding the QRS onset by 15-35 msec 
      (mean: 22 msec) and His-bundle pacing produced a nearly identical ECG to clinical 
      VT/VPCs. The HIS group R wave amplitude in the inferior leads (lead III: 1.0 +/- 
      0.6 mV) was significantly lower than that of the RVOT group (1.7 +/- 0.4 mV, P < 
      0.05). An R wave in aVL was present in 6 of 10 HIS group patients, while almost 
      all RVOT group patients had a QS pattern in aVL. Lead I in HIS group exhibited 
      significantly taller R wave amplitudes than RVOT group. HIS group QRS duration in 
      the inferior leads was shorter than that of the RVOT group. Eight of 10 HIS group 
      patients exhibited a QS pattern in lead V1 compared to 14 of 81 RVOT group 
      patients. HIS group had larger R wave amplitudes in leads V5 and V6 than RVOT 
      group. CONCLUSION: VT/VPCs originating near the His-bundle have distinctive ECG 
      characteristics. Knowledge of the characteristic QRS morphology may facilitate 
      catheter mapping and successful ablation.
FAU - Yamauchi, Yasuteru
AU  - Yamauchi Y
AD  - Division of Cardiology, Musashino Red Cross Hospital, Tokyo, Japan. 
      yamauchi@musashino.jrc.or.jp
FAU - Aonuma, Kazutaka
AU  - Aonuma K
FAU - Takahashi, Atsushi
AU  - Takahashi A
FAU - Sekiguchi, Yukio
AU  - Sekiguchi Y
FAU - Hachiya, Hitoshi
AU  - Hachiya H
FAU - Yokoyama, Yasuhiro
AU  - Yokoyama Y
FAU - Kumagai, Koji
AU  - Kumagai K
FAU - Nogami, Akihiko
AU  - Nogami A
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 Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
MH  - Adult
MH  - Aged
MH  - Bundle of His/*physiopathology/surgery
MH  - Bundle-Branch Block/physiopathology
MH  - Catheter Ablation
MH  - *Electrocardiography
MH  - Electrophysiologic Techniques, Cardiac
MH  - Female
MH  - Heart Ventricles/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Tachycardia, Ventricular/*physiopathology/surgery
MH  - Treatment Outcome
MH  - Ventricular Outflow Obstruction/*physiopathology/surgery
EDAT- 2005/09/30 09:00
MHDA- 2006/01/21 09:00
CRDT- 2005/09/30 09:00
PHST- 2005/09/30 09:00 [pubmed]
PHST- 2006/01/21 09:00 [medline]
PHST- 2005/09/30 09:00 [entrez]
AID - JCE40787 [pii]
AID - 10.1111/j.1540-8167.2005.40787.x [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2005 Oct;16(10):1041-8. doi: 
      10.1111/j.1540-8167.2005.40787.x.