Discrete systolic potentials during ventricular tachycardia in patients with prior myocardial infarction

Frank Bogun, Bradley Knight, Rajiva Goyal, Gregory F. Michaud, S. Adam Strickberger, Stefan H. Hohnloser, Fred Morady*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Systolic Potentials. Introduction: Isolated diastolic potentials have been found to be helpful in identifying critical sites for ablation of ventricular tachycardia (VT) in patients with coronary artery disease. However, discrete potentials that occur during systole have not been previously described. The purpose of this study was to determine the significance of discrete systolic potentials during VT in patients with coronary artery disease. Methods and Results: Twenty-seven patients with a mean age of 66 ± 12 years (± standard deviation) who had coronary artery disease underwent radiofrequency catheter ablation of 42 VTs that had a mean cycle length of 486 ± 78 msec. The only criterion used to select target sites for ablation was concealed entrainment, which was present at 92 sites. Thirty-five of the 42 VTs (83%) were successfully ablated. A discrete systolic potential was recorded during 7 of the 42 VTs (17%). In all cases, the interval between the discrete systolic potential and the next QRS complex was equal to the stimulus-QRS interval during concealed entrainment. At all seven sites where a discrete systolic potential was recorded, delivery of radiofrequency energy resulted in successful ablation of the VT. Conclusion: Discrete systolic potentials may be present in patients with coronary artery disease in approximately 17% of VTs in which there is concealed entrainment. If the interval between the discrete systolic potential and the next QRS complex matches the stimulus-QRS interval during concealed entrainment, delivery of radiofrequency energy is likely to result in successful ablation of the VT.

Original languageEnglish (US)
Pages (from-to)364-369
Number of pages6
JournalJournal of cardiovascular electrophysiology
Volume10
Issue number3
DOIs
StatePublished - 1999

Keywords

  • Concealed entrainment
  • Systolic potential
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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