Key result
Radiofrequency current applied to the diastolic and presystolic potentials at the left upper septum successfully suppressed the ventricular tachycardia.
Case Report (n=1)
Idiopathic left upper septal VT may represent an antidromic macroreentry of the common form of ILVT, which can be successfully treated with targeted radiofrequency ablation.
May support targeted ablation at left upper septal potentials in this VT; hypothesis-generating for antidromic macroreentry mechanism.
A 36-year-old male presented with verapamil-sensitive narrow QRS tachycardia. The patient underwent the catheter ablation of common idiopathic left fascicular ventricular tachycardia (ILVT) 2 years ago. During narrow QRS tachycardia, the diastolic and presystolic potentials (P1 and P2) were recorded at the left septum. Activation sequences of P1 and P2 were opposite from those in common ILVT. Entrainment of P1 at the upper septum exhibited concealed fusion and S-QRS equal to P1-QRS. Radiofrequency current to P1 suppressed VT. Idiopathic left upper septal VT might be the antidromic macroreentry of the common form of ILVT.
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Nishiuchi et al. (2012) conducted a case report in Verapamil-sensitive narrow QRS tachycardia (n=1). Radiofrequency catheter ablation was evaluated on Suppression of ventricular tachycardia. Radiofrequency current applied to the diastolic and presystolic potentials at the left upper septum successfully suppressed the ventricular tachycardia.
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