Location of diastolic potentials in reentrant circuits causing sustained ventricular tachycardia in the infarcted canine heart: Relationship to predicted critical ablation sites

Candido Cabo, Heiko Schmitt, Gregory Masters, James Coromilas, Andrew L. Wit, Melvin M. Scheinman

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background-The complete reentrant circuit for ablation of reentrant ventricular tachycardia (VT) in humans can rarely be localized by mapping. As a result, surrogate markers, such as diastolic electrical activity, subsequently confirmed by entrainment, have been used. However, ablation at those sites has had variable efficacy. The reasons for this variability are not clear. Methods and Results-We correlated activation maps of reentrant circuits in the epicardial border zone of 4-day old infarcted dog hearts with the corresponding ECGs for 45 VTs to determine the regions of the reentrant circuits activated during diastole. In VTs with a figure-8 reentrant pattern, the center point of the central common pathway, the part of the circuit critical for the maintenance of reentry, was activated in early diastole in 32 of 35 VTs (91.4%), in late diastole in 1 (2.9%), and in systole in 2 (5.7%). Regions outside the circuit were rarely activated in diastole. In 10 VTs, the reentrant circuit was characterized by a single reentrant loop. In these circuits, no one region was predicted to be critical for maintenance of reentry, and a segment of the circuits was activated during diastole. However, regions peripheral to the circuit were also activated during diastole. Conclusions-The pattern of reentrant activation determines the specificity of diastolic activity for locating critical sites for ablation of VT.

Original languageEnglish (US)
Pages (from-to)2598-2607
Number of pages10
JournalCirculation
Volume98
Issue number23
DOIs
StatePublished - Dec 8 1998
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Keywords

  • Ablation
  • Mapping
  • Myocardial infarction
  • Reentry
  • Tachycardia

Fingerprint Dive into the research topics of 'Location of diastolic potentials in reentrant circuits causing sustained ventricular tachycardia in the infarcted canine heart: Relationship to predicted critical ablation sites'. Together they form a unique fingerprint.

Cite this