False Tendons in the Left Ventricle: Implications for Successful Ablation of Left Posterior Fascicular Tachycardias.
JACC Clin Electrophysiol
; 9(9): 1914-1929, 2023 09.
Article
em En
| MEDLINE
| ID: mdl-37480871
ABSTRACT
BACKGROUND:
The anatomical substrate for left posterior fascicular ventricular tachycardia (LPF-VT) is still unclear.OBJECTIVES:
The purpose of this study is to describe the endocavitary substrate of the re-entrant loop of LPF-VT.METHODS:
A total of 26 consecutive patients with LPF-VT underwent an electrophysiology study and radiofrequency ablation.RESULTS:
Intracardiac echocardiography imaging observed a 100% prevalence of false tendons (FTs) at the left posterior septal region in all patients, and 3 different types of FTs could be classified according to their location. In 22 patients, a P1 potential could be recorded via the multielectrode catheter from a FT. In 4 patients without a recorded P1 during LPF-VT, the earliest P2 potentials were recorded from a FT in 3 patients, and from a muscular connection between 2 posteromedial papillary muscles in 1 patient. Catheter ablation focused on the FTs with P1 or earliest P2 (in patients without P1) was successful in all 26 patients. After 19 ± 8.5 months of follow-up, no patients had recurrence of LPF-VT.CONCLUSIONS:
FTs provide an electroanatomical substrate for LPF-VT and a "culprit FT" may be identified as the critical structure bridging the macro-re-entrant loop. Targeting the "culprit FT" is a novel anatomical ablation strategy that results in long-term arrhythmia-free survival.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Taquicardia Ventricular
/
Ablação por Cateter
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article