Activation mapping combined with radiofrequency ablation in treating left ventricular posterior fascicular tachycardia under sinus rhythm

WANG Ying; ZENG Shan; TIAN Zhiyu; ZHAO Peng

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Medical Journal of the Chinese People Armed Police Forces ›› 2019, Vol. 30 ›› Issue (12) : 1068-1071.

Activation mapping combined with radiofrequency ablation in treating left ventricular posterior fascicular tachycardia under sinus rhythm

WANG Ying, ZENG Shan,TIAN Zhiyu, ZHAO Peng

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Abstract

Objective To evaluate the therapeutic effect of activation mapping combined with radiofrequency ablation under sinus rhythm against left ventricular posterior fascicular tachycardia (LVPFT).Methods Radiofrequency ablation was performed on six patients hospitalized in the Characteristic Medical Center of Chinese Armed Police Force between October 2016 and September 2018 [five males, one female, aged 18 to 33 and the mean age (24.4±5.8) years]. None of the patients had any organic heart disease. Carto-3 system was used to construct the left posterior septal fascicular area under sinus rhythm. The earliest V wave was mapped in this area under induced ventricular tachycardia. The fractionated Purkinje potential (PP) was mapped and ablated near the earliest V wave after conversion to sinus rhythm. At about 1 cm upper the ablation point, the normal PP potential was mapped and ablated until it disappeared, or the inferior wall leads of ECG on the body surface were qR-shaped.Results Surgery was a success in all the six cases. The duration of surgery was (117.5±15.1)min, X-ray dose(77.5±32.9)mGy, average number of times of ablation(6.5±1.5)and the duration of ablation was (4.7±1.5)min. There were no serious complications. All the patients were free of symptoms without antiarrhythmic drugs during the mean follow-up of (16.5±8.4)months (ranging from six to thirty months).Conclusions Activation mapping combined with radiofrequency ablation under sinus rhythm for LVPFT is safe, effective and clinically feasible.

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radiofrequency catheter ablation / idiopathic left ventricular tachycardia / left ventricular posterior fascicular tachycardia / fractionated Purkinje potential

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WANG Ying, ZENG Shan,TIAN Zhiyu, ZHAO Peng. Activation mapping combined with radiofrequency ablation in treating left ventricular posterior fascicular tachycardia under sinus rhythm[J]. Medical Journal of the Chinese People Armed Police Forces. 2019, 30(12): 1068-1071

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