Verapamil-Sensitive Upper Septal Idiopathic Left Ventricular Tachycardia: Prevalence, Mechanism, and Electrophysiological Characteristics

JACC. Clinical Electrophysiology
Ahmed Karim TalibKazutaka Aonuma

Abstract

This study sought to demonstrate the prevalence, mechanism, and electrocardiographic and electrophysiological characteristics of upper septal idiopathic left fascicular ventricular tachycardia (US-ILVT). ILVT is classified into left anterior and posterior types with no clear data about US-ILVT. Among 193 ILVT patients, we identified 12 patients (6.2%; age 41 ± 22 years, 7 men) with US-ILVT. Of 12 patients with US-ILVT, 6 patients (50%) had previous history of radiofrequency catheter ablation for common ILVT. Sustained VT (cycle length: 349 ± 53 ms) was seen in all patients with a QRS interval slightly wider (104 ± 18 ms) than that during sinus rhythm (90 ± 19 ms). The VT exhibited an identical QRS configuration as sinus rhythm in 6 (50%) and incomplete right bundle branch block configuration in another 6. His-ventricular interval during VT was always shorter than that during sinus rhythm (27 ± 5 ms vs. 47 ± 10 ms). Purkinje potentials were activated in a reverse direction to that of common ILVT; namely, the diastolic potential (P1) was activated retrogradely but the pre-systolic potential (P2) was activated antegradely. At the left upper-middle ventricular septum, P1 potential was recorded during VT, preceding the QRS by 54 ± 2...Continue Reading

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Citations

Mar 16, 2017·Circulation. Arrhythmia and Electrophysiology·Yuki KomatsuKazutaka Aonuma
Jan 15, 2017·Circulation. Arrhythmia and Electrophysiology·Suraj KapaSamuel J Asirvatham
May 11, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Edmond M CroninUNKNOWN ESC Scientific Document Group
Jun 28, 2020·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Yulong Xiong, Hongling Zhu
Jan 28, 2020·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Edmond M CroninKatja Zeppenfeld
Aug 27, 2019·European Heart Journal. Case Reports·Junji YamaguchiKenzo Hirao
Jul 21, 2020·Arrhythmia & Electrophysiology Review·Hongwu ChenMinglong Chen
Jun 4, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Akihiko NogamiUNKNOWN JCS/JHRS Joint Working Group
Jul 22, 2020·The American Journal of Emergency Medicine·Oscar M P Jolobe
Aug 14, 2021·Journal of Arrhythmia·Akihiko NogamiUNKNOWN JCS/JHRS Joint Working Group
Oct 5, 2021·Circulation. Arrhythmia and Electrophysiology·Mohan N ViswanathanMelvin M Scheinman

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