Authors: Itsuro Morishima Akihiko Nogami Hideyuki Tsuboi Takahito Sone
Publish Date: 2008/07/04
Volume: 22, Issue: 3, Pages: 233-
Abstract
Uncommon association of left anterior fascicular ventricular tachycardia VT with a healed myocardial infarction MI is described A 55yearold man with a history of anteroseptal MI had verapamilsensitive VT The VT exhibited a right bundle branch block configuration and rightaxis deviation The VT exit was located at the left ventricular anterolateral wall At the midanterior left ventricular septum delayed Purkinje potentials were seen during sinus rhythm and the optimal pace map was obtained with pace delay During the VT diastolic and systolic Purkinje potentials were simultaneously recorded at the same site Ablation targeting the delayed potentials during sinus rhythm prolonged the time between QRS onset and the delayed potentials and the VT no longer became inducible when the delayed potentials were completely eliminated Left anterior fascicular VT develops in postMI patients ischemiainjured HisPurkinje system may be involved in the mechanism of the VT
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