ILVT-刘少稳.pptVIP

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2017-06-21 发布于湖北
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ILVT-刘少稳.ppt

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ILVT-刘少稳

ILVT--RBBB+Left axis deviation Ablation approach 1 Ablation approach 1 Ablation approach 2 Ablation approach 2 Ablation approach 2 Ablation approach 2 Ablation approach 2 Ablation approach 2 Ablation approach 3 Ablation approach 3 Ablation approach 4 Ablation approach 4Ouyang F, et al. Electroanatomic substrate of ILVT: unidirectional block and macroreentry within the purkinje network. Circulation 2002;105:462. Ablation approach 4 Radiofrequency ablation of idiopathic left anterior fascicular tachycardia Bogun F, et al. RF ablation of idiopathic left anterior fascicular tachycardia. JCE 1995;6:1113. Rodriguez LM, et al. RF catheter ablation of idiopathic ventricular tachycardia originating in the anterior fascicle of the left bundle branch. JCE 1996;7:1211. Damle RS, et al. RF catheter ablation of idiopathic left ventricular tachycardia originating in the left anterior fascicle. Pacing Clin Electrophysiol 1998;21:1155. Nogami A, et al. Verapamil-sensitive left anterior fascicular ventricular tachycardia: results of RF ablation in six patients. JCE 1998;9:1269. Ablation of Idiopathic Left Anterior Fascicular Tachycardia RetroPP were more frequently observed within the posterior fascicle (49/63, 78%) than within the anterior one (18/50, 36%, p0.0001). The earliest and latest potential were recorded 116 ms and 517 ms after the presystolic PP within the anterior fascicular network, 101 ms and 520 ms within the posterior one. Multiple retroPP and/or a short PP-to-retroPP interval could only be identified at the proximal area of anterior and posterior posterior fascicle. Mechanism of ILVT Ablation Approaches of ILVT Reproducible sustained ILVT: Exit site of reentrant circuit: earliest ventricular activation with fused presystolic PP with or without pace mapping Slow conduction of reentrant circuit: LDP Non-sustained ILVT: Anatomic ablation approach Identifying the critical part of reentrant circuit