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Idiopathic Fascicular Ventricular Tachycardia

By Johnson Francis, Venugopal K, Khadar SA, Sudhayakumar N and Anoop K Gupta

Abstract

Idiopathic fascicular ventricular tachycardia is an important cardiac arrhythmia with specific electrocardiographic features and therapeutic options. It is characterized by relatively narrow QRS complex and right bundle branch block pattern. The QRS axis depends on which fascicle is involved in the re-entry. Left axis deviation is noted with left posterior fascicular tachycardia and right axis deviation with left anterior fascicular tachycardia. A left septal fascicular tachycardia with normal axis has also been described. Fascicular tachycardia is usually seen in individuals without structural heart disease. Response to verapamil is an important feature of fascicular tachycardia. Rare instances of termination with intravenous adenosine have also been noted. A presystolic or diastolic potential preceding the QRS, presumed to originate from the Purkinje fibers can be recorded during sinus rhythm and ventricular tachycardia in many patients with fascicular tachycardia. This potential (P potential) has been used as a guide to catheter ablation. Prompt recognition of fascicular tachycardia especially in the emergency department is very important. It is one of the eminently ablatable ventricular tachycardias. Primary ablation has been reported to have a higher success, lesser procedure time and fluoroscopy time

Topics: Indian Pacing and Electrophysiology Journal
Publisher: Indian Pacing and Electrophysiology Group
Year: 2004
OAI identifier: oai:cogprints.org:4190

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Citations

  1. (2003). Adenosine-sensitive wide-complex tachycardia: an uncommon variant of idiopathic fascicular ventricular tachycardia--a case report. Angiology. doi
  2. (1996). Anatomic Substrate for Idiopathic Left Ventricular Tachycardia. Circulation.
  3. (1979). Atrial induction of ventricular tachycardia: reentry versus triggered automaticity.
  4. (1988). Benign ventricular tachycardia in systemic sarcoidosis--a case of false tendon.
  5. Entrainment of idiopathic ventricular tachycardia of left ventricular origin with evidence for re-entry with an area of slow conduction and effect of verapamil.
  6. Fascicular tachycardias sensitive to calcium antagonists.
  7. (2002). Idiopathic left ventricular tachycardia: assessment and treatment. Card Electrophysiol Rev.
  8. (1993). Idiopathic Left Ventricular Tachycardia: Cure by Radiofrequency Ablation. Circulation.
  9. (1984). Idiopathic recurrent sustained ventricular tachycardia responsive to verapamil: an ECG-electrophysiologic entity. Am Heart J.
  10. (1998). Incessant fascicular tachycardia: a cause of arrhythmia induced cardiomyopathy. Pacing Clin Electrophysiol. doi
  11. (2003). Is the fascicle of left bundle branch involved in the reentrant circuit of verapamil-sensitive idiopathic left ventricular tachycardia? Pacing Clin Electrophysiol.
  12. (1986). Persistent ventricular tachycardia resulting in left ventricular dilatation treated with verapamil.
  13. (2002). Primary radiofrequency ablation for incessant idiopathic ventricular tachycardia. Pacing Clin Electrophysiol. doi
  14. (1994). Radiofrequency ablation of fascicular tachycardia: efficacy of pace-mapping and implications on tachycardia origin.
  15. Radiofrequency catheter ablation of idiopathic left ventricular tachycardia guided by a Purkinje potential.
  16. Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease.
  17. (1992). Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease. Circulation. doi
  18. (1981). Response of recurrent sustained ventricular tachycardia to verapamil. Br Heart J.
  19. (1988). Termination of idiopathic ventricular tachycardia with QRS morphology of right bundle branch block and anterior fascicular hemiblock (fascicular tachycardia) by vagal maneuvers. Presentation of 4 cases.
  20. (1987). Treatment of resistant ventricular tachycardia by endocavitary fulguration associated with anti-arrhythmic therapy. Eur Heart J.
  21. Ventricular tachycardia induced by atrial stimulation in patients without symptomatic cardiac disease.
  22. (1972). Ventricular tachycardia with narrow QRS complexes (left posterior fascicular tachycardia). Circulation.
  23. (1991). Verapamil and ventricular tachycardias.
  24. (1986). Verapamil in idiopathic ventricular tachycardia of right bundle-branch block morphology: observations during electrophysiological and exercise testing. Pacing Clin Electrophysiol.
  25. (1998). Verapamil-sensitive left anterior fascicular ventricular tachycardia: results of radiofrequency ablation in six patients. J Cardiovasc Electrophysiol.

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