Abstract
After entrainment pacing, the postpacing interval of a diastolic potential may be misinterpreted if the distal tip of the ablation catheter captures a remote bystander pathway adjacent to the critical isthmus of a complex reentrant circuit in a structurally diseased heart. We discuss this possible pitfall of entrainment mapping of reentrant ventricular tachycardia, observed after a healed myocardial infarction.
Highlights
Entrainment mapping is a key maneuver used to locate the critical isthmus of a reentrant circuit during catheter ablation of a reentrant ventricular tachycardia (VT). [1] The postpacing interval (PPI) of the diastolic potential (DP), reflective of the activation in the zone of slowO
Keywords Ventricular tachycardia Á Reentrant tachycardia Á Entrainment mapping Á Postpacing interval Á Critical isthmus Á Remote bystander pathway conduction following entrainment pacing limited to the critical isthmus, is typically equal to the tachycardia cycle length (TCL) [1], whereas the PPI of a DP during entrainment pacing outside the critical isthmus is of electrophysiologic interest [2, 3]
We describe the electrophysiologic behavior and significance of the PPI after entrainment pacing of a remote bystander pathway near the reentry circuit of VT after a healed anteroseptal myocardial infarction, followed by autopsy of the heart
Summary
Yoshiaki Kaneko • Tadashi Nakajima • Tadanobu Irie • Osamu Igawa • Takafumi Iijima • Masaki Ota • Mio Tamura • Takashi Iizuka • Shuntaro Tamura • Akihiro Saito • Masahiko Kurabayashi Received: 18 March 2013 / Accepted: 6 September 2013 / Published online: 24 September 2013 Ó The Author(s) 2013. This article is published with open access at Springerlink.com
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