Evidence for Slow Conduction Areas during Pacing in Patients with Sinus Rhythm, and their Relation to the Site of VT Origin.

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概要

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• In 52 patients with reentrant monomorphic sustained ventricular tachycardia (VT), the site of VT origin was determined by endocardial mapping and the interval from stimulus artifact to the onset of QRS complex (StQRS) was measured during pace-mapping. Eleven patients had remote myocardial infarction (group 1), 25 patients had other underlying heart diseases (group 2), and 16 had idiopathic VT (group 3). A St-QRS interval of 40msec or longer was defined as abnormal. (1) Long St-QRS interval: Thirteen sites with long St-QRS intervals were detected in 13 (25.0%) of 52 patients: 5 patients in group 1 (45.5%), 7 (28.0%) patients in group 2 and one (6.3%) in group 3. (2) Local electrogram: The local electrogram at sites with a long StQRS interval was wide and 113±38msec in duration during sinus rhythm which increased to 159±64msec during VT (p<0.05). In sinus rhythm, an abnormally prolonged local electrogram was observed in 11 of 13 sites with a long St-QRS interval, and mid-diastolic potential or continuous activity was observed in 3 sites during VT. (3) Relation to VT origin: At sites with a long StQRS interval, concealed entrainment was observed in 3 patients, and the earliest activated local electrogram during VT in 5 patients. Conclusion: Sites with a long ST-QRS interval were observed in 25% of the patients with VT, and their incidence tended to be higher in patients with ischemic heart disease. Such sites were associated with abnormal local electrograms and some of the sites were considered to be the active limb of the reentry circuit.

• International Heart Journal刊行会の論文

著者

• Chinushi Masaomi

  First Department Of Internal Medicine Niigata University School Of Medicine

• Washizuka Takashi

  First Department Of Internal Medicine Niigata University School Of Medicine

• Shibata Akira

  First Department Of Internal Medicine Niigata University Niigata Case Western Reserve University

• Kusano Yoriko

  First Department Of Internal Medicine Niigata University School Of Medicine

• Aizawa Yoshifusa

  First Department Of Internal Medicine Niigata Universaity School Of Medicine

• WASHIZUKA Takashi

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

• AIZAWA Yoshifusa

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

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