Cogprints

Idiopathic Fascicular Ventricular Tachycardia

Francis, Johnson and K, Venugopal and SA, Khadar and N, Sudhayakumar and Gupta, Anoop K (2004) Idiopathic Fascicular Ventricular Tachycardia. [Journal (Paginated)]

Full text available as:

[img]
Preview
PDF
198Kb
[img] HTML
57Kb

Abstract

Idiopathic fascicular ventricular tachycardia is an important cardiac arrhythmia with specific electrocardiographic features and therapeutic options. It is characterized by relatively narrow QRS complex and right bundle branch block pattern. The QRS axis depends on which fascicle is involved in the re-entry. Left axis deviation is noted with left posterior fascicular tachycardia and right axis deviation with left anterior fascicular tachycardia. A left septal fascicular tachycardia with normal axis has also been described. Fascicular tachycardia is usually seen in individuals without structural heart disease. Response to verapamil is an important feature of fascicular tachycardia. Rare instances of termination with intravenous adenosine have also been noted. A presystolic or diastolic potential preceding the QRS, presumed to originate from the Purkinje fibers can be recorded during sinus rhythm and ventricular tachycardia in many patients with fascicular tachycardia. This potential (P potential) has been used as a guide to catheter ablation. Prompt recognition of fascicular tachycardia especially in the emergency department is very important. It is one of the eminently ablatable ventricular tachycardias. Primary ablation has been reported to have a higher success, lesser procedure time and fluoroscopy time.

Item Type:Journal (Paginated)
Keywords:Ventricular Tachycardia, Structural Normal Heart, Radiofrequency ablation
Subjects:JOURNALS > Indian Pacing and Electrophysiology Journal
ID Code:4190
Deposited By: Indian Pacing and Electrophysiology, Journal
Deposited On:13 Apr 2005
Last Modified:11 Mar 2011 08:55

References in Article

Select the SEEK icon to attempt to find the referenced article. If it does not appear to be in cogprints you will be forwarded to the paracite service. Poorly formated references will probably not work.

1. Cohen HC, Gozo EG Jr, Pick A. Ventricular tachycardia with narrow QRS complexes (left posterior fascicular tachycardia). Circulation. 1972 May; 45(5): 1035-43.

2. Zipes DP, Foster PR, Troup PJ, Pedersen DH. Atrial induction of ventricular tachycardia: reentry versus triggered automaticity. Am J Cardiol. 1979; 44:1-8.

3. Belhassen B, Rotmensch HH, Laniado S. Response of recurrent sustained ventricular tachycardia to verapamil. Br Heart J. 1981 Dec; 46(6): 679-82.

4. Toivonen L, Nieminen M. Persistent ventricular tachycardia resulting in left ventricular dilatation treated with verapamil. Int J Cardiol. 1986; 13(3): 361-5.

5. Tai YT, Chow WH, Lau CP, Yau CC. Verapamil and ventricular tachycardias. Chin Med J (Engl). 1991 Jul; 104(7): 567-72.

6. Ward DE, Nathan AW, Camm AJ. Fascicular tachycardias sensitive to calcium antagonists. Eur Heart J. 1984;5:896-905.

7. Sethi KK, Manoharan S, Mohan JC, Gupta MP. Verapamil in idiopathic ventricular tachycardia of right bundle-branch block morphology: observations during electrophysiological and exercise testing. Pacing Clin Electrophysiol. 1986;9:8-16.

8. Belhassen B, Shapira I, Pelleg A, Copperman I, Kauli N, Laniado S. Idiopathic recurrent sustained ventricular tachycardia responsive to verapamil: an ECG-electrophysiologic entity. Am Heart J. 1984 Oct; 108(4 Pt 1): 1034-7.

9. Wellens HJJ, Smeets JLRM. Idiopathic Left Ventricular Tachycardia: Cure by Radiofrequency Ablation. Circulation. 1993; 88(6): 2978-2979.

10. Thakur RK, Klein GJ, Sivaram CA et al. Anatomic Substrate for Idiopathic Left Ventricular Tachycardia. Circulation. 1996;93:497-501.

11. Buja G, Folino A, Martini B et al. Termination of idiopathic ventricular tachycardia with QRS morphology of right bundle branch block and anterior fascicular hemiblock (fascicular tachycardia) by vagal maneuvers. Presentation of 4 cases. G Ital Cardiol. 1988 Jul; 18(7): 560-6.

12. Klein LS, Shih H, Hackett FK, Zipes DP, Miles WM. Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease. Circulation. 1992;85:1666-1674.

13. German LD, Packer DI, Bardy GH, Gallagher JJ. Ventricular tachycardia induced by atrial stimulation in patients without symptomatic cardiac disease. Am J Cardiol. 1983;52:1202-1207.

14. Okumura K, Matsuyama K, Miyagi II, Tsuchlya T, Yasue H. Entrainment of idiopathic ventricular tachycardia of left ventricular origin with evidence for re-entry with an area of slow conduction and effect of verapamil. Am J Cardiol. 1988;62:727-732.

15. Lau CP. Radiofrequency ablation of fascicular tachycardia: efficacy of pace-mapping and implications on tachycardia origin. Int J Cardiol. 1994 Oct; 46(3): 255-65.

16. Nogami A, Naito S, Tada H et al. Verapamil-sensitive left anterior fascicular ventricular tachycardia: results of radiofrequency ablation in six patients. J Cardiovasc Electrophysiol. 1998 Dec; 9(12): 1269-78.

17. Kuo JY, Tai CT, Chiang CE et al. Is the fascicle of left bundle branch involved in

the reentrant circuit of verapamil-sensitive idiopathic left ventricular tachycardia? Pacing Clin Electrophysiol. 2003 Oct; 26(10): 1986-92.

18. Nogami A. Idiopathic left ventricular tachycardia: assessment and treatment. Card Electrophysiol Rev. 2002 Dec; 6(4): 448-57.

19. Nakagawa H, Beckman KJ, McClelland JH, et al. Radiofrequency catheter ablation of idiopathic left ventricular tachycardia guided by a Purkinje potential. Circulation. 1993;88:2607-2617.

20. Kudoh Y, Hiraga Y, Iimura O. Benign ventricular tachycardia in systemic sarcoidosis--a case of false tendon. Jpn Circ J. 1988 Apr; 52(4): 385-9.

21. Chiaranda G, Di Guardo G, Gulizia M, Lazzaro A, Regolo T. Ital Heart J. 2001 Nov; 2(11 Suppl): 1181-6.

22. Anselme F, Boyle N, Josephson M. Incessant fascicular tachycardia: a cause of arrhythmia induced cardiomyopathy. Pacing Clin Electrophysiol. 1998; 21: 760-3.

23. Kassotis J, Slesinger T, Festic E, Voigt L, Reddy CV. Adenosine-sensitive wide-complex tachycardia: an uncommon variant of idiopathic fascicular ventricular tachycardia--a case report. Angiology. 2003 May-Jun; 54(3): 369-72.

24. Fontaine G, Tonet JL, Frank R et al. Treatment of resistant ventricular tachycardia by endocavitary fulguration associated with anti-arrhythmic therapy. Eur Heart J. 1987 Aug; 8 Suppl D: 133-41.

25. Klein LS, Shih H, Hackett FK, Zipes DP, Miles WM. Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease. Circulation. 1992;85:1666-1674.

26. Gupta AK, Kumar AV, Lokhandwala YY et al. Primary radiofrequency ablation for incessant idiopathic ventricular tachycardia. Pacing Clin Electrophysiol. 2002 Nov; 25(11): 1555-60.

Metadata

Repository Staff Only: item control page