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Related Experiment Videos

Recurrent sustained ventricular tachycardia. 2. Endocardial mapping.

M E Josephson, L N Horowitz, A Farshidi

    Circulation
    |March 1, 1978
    PubMed
    Summary
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    Endocardial ventricular mapping precisely located the origin of ventricular tachycardia (VT), revealing limitations of surface electrocardiograms. This technique offers crucial data for surgical VT treatment strategies.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Cardiac Surgery

    Background:

    • Ventricular tachycardia (VT) is a significant cause of sudden cardiac death.
    • Accurate localization of VT origin is crucial for effective treatment, including surgical intervention.
    • Surface electrocardiogram (ECG) interpretation has limitations in precisely identifying VT origins.

    Purpose of the Study:

    • To evaluate the efficacy of endocardial ventricular mapping in determining the site of origin for various types of VT.
    • To compare the accuracy of endocardial mapping with surface ECG findings.
    • To assess the utility of endocardial mapping in guiding surgical therapy for VT.

    Main Methods:

    • Performed endocardial ventricular mapping using electrode catheters in 17 patients with 21 VT episodes.

    Related Experiment Videos

  • Analyzed activation patterns at multiple left and right ventricular sites.
  • Correlated mapping findings with QRS morphology (left bundle branch block pattern [VT-LBBB] and right bundle branch block pattern [VT-RBBB]) and presence of ventricular aneurysms.

    • Main Results:

    • In all VT-RBBB, the earliest activation site was in the left ventricle (LV) or septum.
    • In VT-LBBB, earliest activation sites included the right ventricle (RV) (4/11), LV (5/11), and septum (2/11).
    • VT with QRS duration <140 ms originated in the septum; VT in patients with aneurysms arose within the aneurysm, particularly septal aneurysms in VT-LBBB.

    Conclusions:

    • Endocardial ventricular mapping accurately localizes VT origins, surpassing surface ECG limitations.
    • Mapping data provides essential information for planning surgical interventions for VT.
    • QRS changes during VT reflect altered activation patterns but not a change in the VT origin site.