Termination of ventricular tachycardia in the human heart. Insights from three-dimensional mapping of nonsustained and sustained ventricular tachycardias

Circulation
Steven M PogwizdM E Cain

Abstract

To define the electrophysiological basis for the termination of ventricular tachycardia (VT), three-dimensional cardiac mapping and analysis of the terminal beats of nonsustained VT and beats of sustained VT were performed in six patients with healed myocardial infarcts. Termination of VT was due to activation from multiple initiation sites that were discordant from those responsible for the maintenance of sustained VT in 45% of cases, to repetitive activation from single sites that were discordant from those responsible for the maintenance of sustained VT in 24% of cases, or to activation from sites concordant with the sites of repetitive activation during sustained VT in 31% of cases. Sustained VT was characterized by occasional shifting of initiation sites, even after the tachycardia entered the stable monomorphic phase. Mapping was of sufficient density to define the mechanisms for 21 terminating beats of VT. In 5 cases, termination was due to intramural reentry, which initiated with the total activation time of the preceding beat of 204 +/- 11 milliseconds (ms) but terminated primarily because of a decrease in total activation time (144 +/- 23 ms, P = .03) that was associated with the development of intramural conduction b...Continue Reading

References

Jan 1, 1983·The American Journal of Cardiology·R F GilmourD P Zipes
Aug 1, 1993·Journal of Cardiovascular Electrophysiology·R L Mitra, A E Buxton

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Citations

Feb 17, 1999·Pacing and Clinical Electrophysiology : PACE·V S PrakashS A Chen
May 29, 2000·Journal of Cardiovascular Electrophysiology·S M Pogwizd
Dec 20, 2011·Journal of Cardiovascular Electrophysiology·Carolyn M Johnson, Steven M Pogwizd
Sep 1, 2006·IEEE Transactions on Bio-medical Engineering·Chenguang LiuBin He
Feb 10, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mina AttinSteven M Pogwizd
Dec 13, 2005·Journal of Internal Medicine·M E Anderson
Aug 17, 2019·American Journal of Physiology. Heart and Circulatory Physiology·Mark L TrewBruce H Smaill
Nov 8, 2001·American Journal of Physiology. Cell Physiology·J L Puglisi, D M Bers
Aug 9, 2005·American Journal of Physiology. Heart and Circulatory Physiology·Xin ZhangBin He

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