Using the principles of transient entrainment to localize a critical area of slow conduction in the reentrant circuit of a ventricular tachycardia is proposed to guide effective ablation therapy.
We have previously shown that demonstration of any of the criteria for transient entrainment is possible only when pacing is performed orthodromically proximal to the area of slow conduction in a reentrant circuit with an excitable gap. Pacing orthodromically distal to the area of slow conduction will not permit demonstration of the transient entrainment criteria (concealed entrainment). Additionally, the demonstration of one form of concealed entrainment, namely pacing during a ventricular tachycardia from a site which increases the tachycardia to the pacing rate but does not change the morphology of the QRS complexes, we suggest also identifies the area of slow conduction is a keystone for maintenance of the reentrant circuit, ablation of this area should be expected to provide effective therapy of the tachycardia. Thus, we propose that using the principles of transient entrainment, one should be able to localize a critical area of slow conduction in the reentrant circuit of a ventricular tachycardia, ablate it effectively, and thereby successfully treat the ventricular tachycardia.
Waldo et al. (Sun,) conducted a other in Ventricular Tachycardia. Transient entrainment for localization of slow conduction area was evaluated. Using the principles of transient entrainment to localize a critical area of slow conduction in the reentrant circuit of a ventricular tachycardia is proposed to guide effective ablation therapy.