Termination of Epicardial Left Ventricular Tachycardia by Pacing without Global Capture

Authors: ASEEM D. DESAI; MARTIN C. BURKE; THOMAS E. HONG; SUSAN KIM; YASSER SALEM; BRADLEY P. KNIGHT

Source: Journal of Cardiovascular Electrophysiology, Volume 16, Number 1, January 2005 , pp. 92-94(3)

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Abstract:

Termination of Epicardial Left Ventricular Tachycardia by Pacing without Global Capture.

It is generally accepted that the diagnosis of an epicardial origin of ventricular tachycardia (VT) can be made indirectly by observing VT termination during ablation on the epicardial surface of the heart. There is a caveat, however, which is that termination of VT during radiofrequency current application on the epicardial surface could be due to extension of the lesion beyond the epicardium. Therefore, successful ablation of VT using an epicardial approach does not necessarily prove the reentrant circuit is located superficially. We present a case of a 44-year-old man with VT storm who demonstrated successful termination of VT with radiofrequency current application on the epicardial surface of the heart. This site corresponded to a site where pacing during VT resulted in termination of VT without global capture. Isolated mid-diastolic potentials were only seen at this site as well. We hypothesize that the finding of termination of VT by pacing without global capture supports the argument that the site of pacing is a critical part of the VT circuit.

(J Cardiovasc Electrophysiol, Vol. 16, pp. 92-94, January 2005)

Keywords: ventricular tachycardia; epicardium; pacing and entrainment; catheter ablation

Document Type: Case report

DOI: http://dx.doi.org/10.1046/j.1540-8167.2005.040538.x

Affiliations: 1: From the Section of Cardiology, Department of Internal Medicine, University of Chicago, Chicago, Illinois, USA

Publication date: 2005-01-01

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