Radiofrequency catheter ablation at the left coronary cusp in treatment of repetitive monomorphic tachycardia of the left ventricular outflow tract  

作　　者：唐恺 马坚 张澍 楚建民 张奎俊 王方正 陈新 

机构地区：[1]Division of Clinical Electrophysiology, Fu Wai Hospital, Beijing 100037, China

出　　处：《Chinese Medical Journal》2004年第2期168-171,共4页中华医学杂志（英文版）

摘　　要：Background The aim of this study was to clarify the electrocardiographic characteristics of repetitive monomorphic ventricular tachycardia (RMVT) originating from the left ventricular outflow tract, and to describe the results of treatment with radiofrequency catheter ablation (RFCA).Methods Routine 12-lead surface electrocardiography and electrophysiological studies were performed on 11 RMVT patients with no organic heart disease, who were subsequently treated with RFCA directed at targets identified by pace mapping.Results The surface electrocardiogram QRS characteristics of RMVT included an atypical left bundle branch block and right axis deviation, with a low amplitude 'rs' or 'rS' pattern in lead I , an 'rS' or 'RS' pattern in V1, and a precordial R wave transition zone in V2 or V3. In 1 patient, a small S wave was observed in V5. Using pace mapping techniques, we selected the left coronary cusp as the ablation target. RMVT was eliminated in all 11 patients immediately after radiofrequency energy delivered. During a follow-up of 13 ±7 months, RMVT recurred in only 1 patient.Conclusion RMVT originating from the left ventricular outflow tract has specific electrocardiographic characteristics, and can be successfully and safely cured using RFCA directed at the left coronary cusp.Background The aim of this study was to clarify the electrocardiographic characteristics of repetitive monomorphic ventricular tachycardia (RMVT) originating from the left ventricular outflow tract, and to describe the results of treatment with radiofrequency catheter ablation (RFCA).Methods Routine 12-lead surface electrocardiography and electrophysiological studies were performed on 11 RMVT patients with no organic heart disease, who were subsequently treated with RFCA directed at targets identified by pace mapping.Results The surface electrocardiogram QRS characteristics of RMVT included an atypical left bundle branch block and right axis deviation, with a low amplitude 'rs' or 'rS' pattern in lead I , an 'rS' or 'RS' pattern in V1, and a precordial R wave transition zone in V2 or V3. In 1 patient, a small S wave was observed in V5. Using pace mapping techniques, we selected the left coronary cusp as the ablation target. RMVT was eliminated in all 11 patients immediately after radiofrequency energy delivered. During a follow-up of 13 ±7 months, RMVT recurred in only 1 patient.Conclusion RMVT originating from the left ventricular outflow tract has specific electrocardiographic characteristics, and can be successfully and safely cured using RFCA directed at the left coronary cusp.

关 键 词：repetitive monomorphic ventricular tachycardia ELECTROCARDIOGRAM catheter ablation left coronary cusp 

分 类 号：R541.7[医药卫生—心血管疾病]