Abstract
Background: Optimal ablation site for arrhythmia foci is conventionally determined by localizing the earliest activation site and sites exhibiting QS-pattern with steep downstroke in local unipolar electrogram (LUE). Morphological characteristics of local bipolar electrogram (LBE) recorded from arrhythmogenic foci, however, remain to be elucidated. Initial component of LBE recorded from arrhythmogenic foci theoretically exhibits upright deflection with steep upstroke (R-pattern), because it represents inversed form of LUE from distal electrode (QS-pattern). Methods and Results: This study included 120 cases with focal arrhythmias (AT=48, RVOT-PVC=72) who underwent catheter ablation. LUE and LBE recorded from successful (120 sites) and unsuccessful ablation sites (320 sites) were reviewed in terms of 1) precedence from the onset of surface P/QRS (δ); 2) morphology of initial component of LUE; and 3) morphology of initial component of LBE. Ablation was successful in all cases. δ was significantly larger in successful sites than in unsuccessful sites (31±7 vs 13±10 msec; P 21 msec (92% and 86%) and QS-pattern in LUE (96% and 88%). Conclusion: Initial upright deflection with steep upstroke in LBE can be another important predictor for successful ablation of arrhythmogenic foci.
Published Version
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