Is the Fascicle of Left Bundle Branch Involved in the Reentrant Circuit of Verapamil-Sensitive Idiopathic Left Ventricular Tachycardia?

Jen Yuan Kuo, Ching Tai Tai, Chern En Chiang, Wen Chung Yu, Jin Long Huang, Ming Hsiung Hsieh, Charles Jia Yin Hou, Cheng Ho Tsai, Yu An Ding, Shih Ann Chen

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Abstract

The exact reentrant circuit of the verapamil-sensitive idiopathic left VT with a RBBB configuration remains unclear. Furthermore, if the fascicle of left bundle branch is involved in the reentrant circuit has not been well studied. Forty-nine patients with verapamil-sensitive idiopathic left VT underwent electrophysiological study and RF catheter ablation. Group I included 11 patients (10 men, 1 woman; mean age 25 ± 8 years) with left anterior fascicular block (4 patients), or left posterior fascicular block (7 patients) during sinus rhythm. Group II included 38 patients (29 men, 9 women; nmean age 35 ± 16 years) without fascicular block during sinus rhythm. Duration of QRS complex during sinus rhythm before RF catheter ablation in group I patients was significant longer than that of group II patients (104 ± 12 vs 95 ± 11 ms, respectively, P = 0.02). Duration of QRS complex during VT was similar between group I and group II patients (141 ± 13 vs 140 ± 14 ms, respectively, P = 0.78). Transitional zones of QRS complexes in the precordial leads during VT were similar between group I and group II patients. After ablation, the QRS duration did not prolong in group I or group II patients (104 ± 11 vs 95 ± 10 ms, P = 0.02); fascicular block did not occur in group IIpatients. Duration and transitional zone of QRS complex during VT were similar between the two groups, and new fascicular block did not occur after ablation. These findings suggest the fascicle of left bundle branch may be not involved in the antegrade limb of reentry circuit in idiopathic left VT.

Original languageEnglish
Pages (from-to)1986-1992
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume26
Issue number10
DOIs
Publication statusPublished - Oct 2003

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Ventricular Tachycardia
Verapamil
Bundle-Branch Block
Catheter Ablation
Extremities

Keywords

  • Ablation
  • Electrophysiology
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Is the Fascicle of Left Bundle Branch Involved in the Reentrant Circuit of Verapamil-Sensitive Idiopathic Left Ventricular Tachycardia? / Kuo, Jen Yuan; Tai, Ching Tai; Chiang, Chern En; Yu, Wen Chung; Huang, Jin Long; Hsieh, Ming Hsiung; Hou, Charles Jia Yin; Tsai, Cheng Ho; Ding, Yu An; Chen, Shih Ann.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 26, No. 10, 10.2003, p. 1986-1992.

Research output: Contribution to journalArticle

Kuo, Jen Yuan ; Tai, Ching Tai ; Chiang, Chern En ; Yu, Wen Chung ; Huang, Jin Long ; Hsieh, Ming Hsiung ; Hou, Charles Jia Yin ; Tsai, Cheng Ho ; Ding, Yu An ; Chen, Shih Ann. / Is the Fascicle of Left Bundle Branch Involved in the Reentrant Circuit of Verapamil-Sensitive Idiopathic Left Ventricular Tachycardia?. In: PACE - Pacing and Clinical Electrophysiology. 2003 ; Vol. 26, No. 10. pp. 1986-1992.
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AU - Tai, Ching Tai

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AU - Yu, Wen Chung

AU - Huang, Jin Long

AU - Hsieh, Ming Hsiung

AU - Hou, Charles Jia Yin

AU - Tsai, Cheng Ho

AU - Ding, Yu An

AU - Chen, Shih Ann

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N2 - The exact reentrant circuit of the verapamil-sensitive idiopathic left VT with a RBBB configuration remains unclear. Furthermore, if the fascicle of left bundle branch is involved in the reentrant circuit has not been well studied. Forty-nine patients with verapamil-sensitive idiopathic left VT underwent electrophysiological study and RF catheter ablation. Group I included 11 patients (10 men, 1 woman; mean age 25 ± 8 years) with left anterior fascicular block (4 patients), or left posterior fascicular block (7 patients) during sinus rhythm. Group II included 38 patients (29 men, 9 women; nmean age 35 ± 16 years) without fascicular block during sinus rhythm. Duration of QRS complex during sinus rhythm before RF catheter ablation in group I patients was significant longer than that of group II patients (104 ± 12 vs 95 ± 11 ms, respectively, P = 0.02). Duration of QRS complex during VT was similar between group I and group II patients (141 ± 13 vs 140 ± 14 ms, respectively, P = 0.78). Transitional zones of QRS complexes in the precordial leads during VT were similar between group I and group II patients. After ablation, the QRS duration did not prolong in group I or group II patients (104 ± 11 vs 95 ± 10 ms, P = 0.02); fascicular block did not occur in group IIpatients. Duration and transitional zone of QRS complex during VT were similar between the two groups, and new fascicular block did not occur after ablation. These findings suggest the fascicle of left bundle branch may be not involved in the antegrade limb of reentry circuit in idiopathic left VT.

AB - The exact reentrant circuit of the verapamil-sensitive idiopathic left VT with a RBBB configuration remains unclear. Furthermore, if the fascicle of left bundle branch is involved in the reentrant circuit has not been well studied. Forty-nine patients with verapamil-sensitive idiopathic left VT underwent electrophysiological study and RF catheter ablation. Group I included 11 patients (10 men, 1 woman; mean age 25 ± 8 years) with left anterior fascicular block (4 patients), or left posterior fascicular block (7 patients) during sinus rhythm. Group II included 38 patients (29 men, 9 women; nmean age 35 ± 16 years) without fascicular block during sinus rhythm. Duration of QRS complex during sinus rhythm before RF catheter ablation in group I patients was significant longer than that of group II patients (104 ± 12 vs 95 ± 11 ms, respectively, P = 0.02). Duration of QRS complex during VT was similar between group I and group II patients (141 ± 13 vs 140 ± 14 ms, respectively, P = 0.78). Transitional zones of QRS complexes in the precordial leads during VT were similar between group I and group II patients. After ablation, the QRS duration did not prolong in group I or group II patients (104 ± 11 vs 95 ± 10 ms, P = 0.02); fascicular block did not occur in group IIpatients. Duration and transitional zone of QRS complex during VT were similar between the two groups, and new fascicular block did not occur after ablation. These findings suggest the fascicle of left bundle branch may be not involved in the antegrade limb of reentry circuit in idiopathic left VT.

KW - Ablation

KW - Electrophysiology

KW - Ventricular tachycardia

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