This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Miller, J. M. Articles by Josephson, M. E. Search for Related Content PubMed PubMed Citation Articles by Miller, J. M. Articles by Josephson, M. E.

Circulation, Vol 72, 1286-1292, Copyright © 1985 by American Heart Association

ARTICLES

Intermittent failure of local conduction during ventricular tachycardia

JM Miller, JA Vassallo, WC Hargrove and ME Josephson

Forty-three patients with sustained ventricular tachycardia (VT) caused by prior myocardial infarction underwent intraoperative endocardial activation mapping during a total of 122 episodes of VT. Electrograms obtained during mapping were analyzed to determine the prevalence of local conduction failure during VT (defined as a portion of the local electrogram that did not repeat with every tachycardia cycle). Local conduction failure during VT was observed in 37 (86%) patients and 73 (65%) tachycardias. VT in which local conduction failure was observed were faster than VTs without local conduction failure (cycle length 315 vs 345 msec; p less than .05). Local conduction failure occurred most frequently at or near sites having the earliest recorded electrical activity during VT ("site of origin"). Twenty-three patients also had sinus rhythm endocardial mapping at the time of surgery. Areas with abnormal or fractionated electrograms in sinus rhythm were more likely to demonstrate local conduction failure in VT than areas with normal electrograms in sinus rhythm (16% vs 8%; p less than .01). Although the mechanism responsible for local conduction failure in VT is unclear, it is a common occurrence and is significant in that it can occasionally mimic "early" sites of endocardial activation, unless enough VT cycles are observed at a given site.

This article has been cited by other articles:

				S. Tung, K. Soejima, W. H. Maisel, M. Suzuki, L. Epstein, and W. G. Stevenson Recognition of far-field electrograms during entrainment mapping of ventricular tachycardia J. Am. Coll. Cardiol., July 2, 2003; 42(1): 110 - 115. [Abstract] [Full Text] [PDF]

				C. Cabo, H. Schmitt, G. Masters, J. Coromilas, A. L. Wit, and M. M. Scheinman Location of Diastolic Potentials in Reentrant Circuits Causing Sustained Ventricular Tachycardia in the Infarcted Canine Heart : Relationship to Predicted Critical Ablation Sites Circulation, December 8, 1998; 98(23): 2598 - 2607. [Abstract] [Full Text] [PDF]