PMID- 7895359
OWN - NLM
STAT- MEDLINE
DCOM- 19950421
LR  - 20190623
IS  - 0009-7322 (Print)
IS  - 0009-7322 (Linking)
VI  - 91
IP  - 7
DP  - 1995 Apr 1
TI  - Body surface potential distributions during idiopathic ventricular tachycardia.
PG  - 2002-9
AB  - BACKGROUND: The purpose of this report is to describe the body surface potential 
      maps (BSPMs) during idiopathic ventricular tachycardia (VT) and to determine what 
      differences exist between different idiopathic VT morphologies. METHODS AND 
      RESULTS: We performed BSPMs during VT on 12 consecutive patients (3 women and 9 
      men; mean age, 42 +/- 13 years) presenting symptomatic idiopathic VT referred to 
      our institution for electrophysiological study. Basal ECG, chest radiograph, and 
      echocardiogram were normal in all patients. Clinical tachycardia showed left 
      bundle branch block pattern (LBBB) in 9 patients, with sustained VT in 5 and 
      nonsustained VT in 4, and right bundle branch block pattern (RBBB) in 3 with 
      sustained VT. We found a unique pattern of BSPMs in each of the 9 patients during 
      idiopathic LBBB VT configuration, whether sustained or nonsustained VT. This 
      pattern appeared at the onset of the QRS and remained stable during the whole QRS 
      complex. The area of minimal potential located in the upper anterior part of the 
      torso was compatible with an origin of VT in the right ventricular outflow tract, 
      as confirmed in 5 patients by successful radiofrequency ablation. We found an 
      evolving pattern with two phases in each of the three RBBB VTs. The electrical 
      axis during the initial part of the QRS could correspond to an 
      endocardial-epicardial vector. The second phase, with a high voltage and area of 
      minimal potential located in the inferior and anterior part of the torso, was 
      compatible with a left ventricular apical origin that was confirmed by epicardial 
      and endocardial mapping during cryosurgery in 1 patient. For all the VTs, the QRS 
      isoarea maps showed the same pattern as the second phase of the QRS. CONCLUSIONS: 
      Two different BSPM patterns were found. All LBBB VTs had the same stable pattern 
      corresponding to an infundibular origin. All RBBB VTs had an evolving pattern 
      that stabilized in the second part of the QRS complex corresponding to an apical 
      origin.
FAU - Klug, D
AU  - Klug D
AD  - Research Center, Hopital du Sacre-Coeur de Montreal, Quebec, Canada.
FAU - Ferracci, A
AU  - Ferracci A
FAU - Molin, F
AU  - Molin F
FAU - Dubuc, M
AU  - Dubuc M
FAU - Savard, P
AU  - Savard P
FAU - Kus, T
AU  - Kus T
FAU - Helie, F
AU  - Helie F
FAU - Cardinal, R
AU  - Cardinal R
FAU - Nadeau, R
AU  - Nadeau R
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - Adult
MH  - *Body Surface Potential Mapping
MH  - Bundle-Branch Block/*diagnosis/physiopathology
MH  - Cardiac Pacing, Artificial
MH  - Catheter Ablation
MH  - Female
MH  - Heart Conduction System/physiopathology/surgery
MH  - Humans
MH  - Male
MH  - Signal Processing, Computer-Assisted
MH  - Tachycardia, Ventricular/*diagnosis/physiopathology/surgery
EDAT- 1995/04/01 00:00
MHDA- 1995/04/01 00:01
CRDT- 1995/04/01 00:00
PHST- 1995/04/01 00:00 [pubmed]
PHST- 1995/04/01 00:01 [medline]
PHST- 1995/04/01 00:00 [entrez]
AID - 10.1161/01.cir.91.7.2002 [doi]
PST - ppublish
SO  - Circulation. 1995 Apr 1;91(7):2002-9. doi: 10.1161/01.cir.91.7.2002.