Localisation of the origin of a ventricular tachycardia: Difference between revisions
Localisation of the origin of a ventricular tachycardia (view source)
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The localisation of the origin (or exit site) of a ventricular tachycardia can be helpful in understanding the cause of the VT and is very helpful when planning an ablation procedure to treat a ventricular tachycardia. | The localisation of the origin (or exit site) of a ventricular tachycardia can be helpful in understanding the cause of the VT and is very helpful when planning an ablation procedure to treat a ventricular tachycardia. | ||
The steps to finding the exit site are: | |||
# What is the bundle branch block (BBB) configuration? | |||
# What is the inferior lead QRS complex polarity? | |||
# What is the lead I QRS complex polarity? | |||
# What is the lead aVL QRS complex polarity? | |||
# What is the lead aVR QRS complex polarity? | |||
# Where is the R-wave transition point? | |||
Using this approach and the algorithms below <cite>segal</cite> the exit site can be estimated with reasonable accuracy (PPV around 70%). In these algorhythms, bundle branch block was defined as “left” or “right” based on QRS morphology in lead V1; right bundle branch block (RBBB) pattern was defined by a mono-, bi-, or triphasic R wave or qR in V1; LBBB pattern was defined by a QS, rS, or qrS in V1. | Using this approach and the algorithms below <cite>segal</cite> the exit site can be estimated with reasonable accuracy (PPV around 70%). In these algorhythms, bundle branch block was defined as “left” or “right” based on QRS morphology in lead V1; right bundle branch block (RBBB) pattern was defined by a mono-, bi-, or triphasic R wave or qR in V1; LBBB pattern was defined by a QS, rS, or qrS in V1. | ||