Inability to capture with increasing current strength: Is this near-field or far-field?

被引:1
作者
Liu, Fang-Zhou [1 ,2 ]
Liao, Hong-Tao [1 ]
Zhan, Xian-Zhang [1 ]
Shehata, Michael [2 ]
Ehdaie, Ashkan [2 ]
Chen, Qiu-Fan [3 ]
Wu, Shu-Lin [1 ]
Xue, Yu-Mei [1 ]
Wang, Xun-Zhang [2 ]
机构
[1] Guangdong Acad Med Sci, Guangdong Cardiovasc Inst, Guangdong Prov Peoples Hosp, Dept Cardiol, Guangzhou, Peoples R China
[2] Cedars Sinai Med Ctr, Smidt Heart Inst, Los Angeles, CA 90048 USA
[3] Zhejiang Univ, Sch Med, Sir Run Run Shaw Hosp, Dept Cardiol, Hangzhou, Peoples R China
基金
中国国家自然科学基金;
关键词
bundle branch re-entry; entrainment; far-field; near-field; VENTRICULAR-TACHYCARDIA; ENTRAINMENT;
D O I
10.1111/jce.14400
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We present a case of wide-complex tachycardia in which the clinical electrophysiological diagnosis was considered to be bundle branch re-entry ventricular tachycardia. A series of ventricular entrainment attempts were performed from the left and right ventricular septum to confirm the diagnosis. Entrainment pacing with a general current output (10 mA) was performed from the right ventricular septum with manifest fusion and a post-pacing interval similar to tachycardia cycle length. Thereafter, another entrainment attempt with a greater current output (20 mA) was performed from the same site. Paradoxically, concealed fusion was demonstrated by selective RB capture only, though there was no clear "RB" potential seen. In this case, we attempt to explain and illustrate the mechanism of paradoxical near-field inability to capture with increasing current strength.
引用
收藏
页码:960 / 963
页数:4
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