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Updated: Mar 29, 2026

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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A novel method to identify the origin of ventricular tachycardia from the left fascicular system

Hongwu Chen1, Fengxiang Zhang1, Bing Yang1

  • 1Cardiology Division, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Heart Rhythm
|December 15, 2015
PubMed

Insights

Predicting the origin of left fascicular tachyarrhythmia (LFTA) is crucial for successful ablation. Measuring the HV interval during normal sinus rhythm (NSR) and LFTA effectively predicts the earliest presystolic potential site.

Area of Science:

  • Electrophysiology
  • Cardiac Arrhythmias
  • Catheter Ablation

Background:

  • Left fascicular tachyarrhythmia (LFTA) ablation strategies are established.
  • Predicting the precise origin of LFTA remains a challenge.

Purpose of the Study:

  • To develop a method for predicting LFTA origin.
  • Utilize HV interval measurements during normal sinus rhythm (NSR) and LFTA.

Main Methods:

  • Calculated predicted earliest presystolic potential (PP) time using HV intervals from NSR and LFTA: (HVNSR + HVLFTA)/2.
  • Mapped earliest retrograde PP during LFTA and correlated with predicted values.

Main Results:

  • Twenty-one LFTA patients analyzed; 19% originated from the left anterior fascicle, 81% from the left posterior fascicle.
  • Predicted PP values closely correlated with mapped values (r = 0.97, P < .001).
  • Successful ablation was achieved in patients with LFTA inducible at baseline but not during mapping.

Conclusions:

  • HV interval measurement during NSR and LFTA accurately predicts the earliest retrograde PP site for LFTA ablation.
  • This prediction method facilitates successful catheter ablation of LFTA.
Abstract

Keywords:
FascicleIdiopathicLeftPredictiveVentricular arrhythmia

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