Key result
Radiofrequency current catheter ablation was successful at a site with earliest and low amplitude Purkinje potential and catheter-induced block, indicating Purkinje fibers are critical to the circuit.
Case Report (n=1)
This case demonstrates that Purkinje fibers are a critical part of the tachycardia circuit in idiopathic left ventricular tachycardia and identifies specific electrogram characteristics for successful ablation sites.
May guide ablation site selection in idiopathic left ventricular tachycardia; hypothesis-generating for Purkinje involvement pending larger studies.
We performed radiofrequency current catheter ablation in a patient with idiopathic LV. While mapping the inferoapical LV septum during tachycardia, spontaneous termination of tachycardia was observed with block between Purkinje (P) potential and ventricular electrogram (P-V block). The cycle length of the tachycardia was associated with prolongation of P-P interval and P-V interval. P potential recording at this site was earliest and at very low amplitude during tachycardia. The radiofrequency current at this site was successful. These findings indicated that Purkinje fiber was a critical part of the tachycardia circuit. Ablation was successful at a site where both an earliest and low amplitude P potential was recorded during tachycardia, and where P-V block that was induced by catheter manipulation was observed during tachycardia.
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Tomokuni et al. (1998) conducted a case report in Idiopathic left ventricular tachycardia (n=1). Radiofrequency current catheter ablation was evaluated on Successful ablation / termination of tachycardia. Radiofrequency current catheter ablation was successful at a site with earliest and low amplitude Purkinje potential and catheter-induced block, indicating Purkinje fibers are critical to the circuit.
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