Comparison of mapping criteria for hemodynamically tolerated, postinfarction ventricular tachycardia

被引：33

作者：

Bogun, F ^{[1
]}

Kim, HM ^{[1
]}

Han, J ^{[1
]}

Tamirissa, K ^{[1
]}

Tschopp, D ^{[1
]}

Reich, S ^{[1
]}

Elmouchi, D ^{[1
]}

Igic, P ^{[1
]}

Lemola, K ^{[1
]}

Good, E ^{[1
]}

Oral, H ^{[1
]}

Chugh, A ^{[1
]}

Pelosi, F ^{[1
]}

Morady, F ^{[1
]}

机构：

[1] Univ Michigan, Med Ctr, Ann Arbor, MI 48109 USA

来源：

HEART RHYTHM | 2006年 / 3卷 / 01期

关键词：

ventricular tachycardia; mapping; postinfarction; radiofrequency ablation;

D O I：

10.1016/j.hrthm.2005.09.014

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Mapping criteria for hemodynamically tolerated, postinfarction ventricular tachycardia (VT) have been evaluated in only small series of patients. OBJECTIVES The purpose of this study was to evaluate the utility of various mapping criteria for identifying a critical VT circuit isthmus in a post hoc analysis. METHODS Ninety VTs (cycle length 491 +/- 84 ms) were mapped in 48 patients with a prior myocardial infarction. The mapping catheter was positioned within a protected area of the reentrant circuit of the targeted VTs at 176 sites. All sites showed concealed entrainment. The predictive values of the following mapping criteria for a successful ablation site were compared: discrete isolated potential during VT, inability to dissociate the isolated potential from the VT, endocardial activation time > 70 ms, matching electrogram-QRS and stimulus-QRS intervals, VT termination without global capture during pacing, stimulus-QRS/VT cycle length ratio <= 0.7, and postpacing interval. For each criterion, the receiver operating characteristic curve was constructed, and the area under the curve was calculated to assess the discriminatory value of the criterion. RESULTS Seventy-eight of 90 VTs (87%) were successfully ablated. The area under the receiver operating characteristic curve was largest (0.89) for matching stimulus-QRS and electrogram-QRS intervals. In combination with an isolated potential that could not be dissociated from the VT, the area under the receiver operating characteristic curve increased to 0.93. CONCLUSION At sites with concealed entrainment, matching stimulus-QRS and electrogram-QRS intervals were superior to other criteria in differentiating a critical isthmus from bystander or noncritical sites in postinfarction VT.

引用

页码：20 / 26

页数：7

共 12 条

[1] Comparison of effective and ineffective target sites that demonstrate concealed entrainment in patients with coronary artery disease undergoing radiofrequency ablation of ventricular tachycardia [J].