Localisation of the origin of a ventricular tachycardia: Difference between revisions

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[[File:VT_origins.svg|thumb|Areas of the left ventricle where VT's can originate from: The left ventricle is depicted as having been opened. Regionsare as follows: '''AB''': anterobasal; '''AM''': mid anterior; '''AA''' anterior apex; '''SB''': basal septum; '''SM''', midseptum; '''SA''', apical septum; '''PB''': basal posterior; '''PM''': mid posterior; '''PA''': posterior apex. Adapted from Miller et al.<cite>Miller</cite>]]
[[File:VT_origins.svg|thumb|Areas of the left ventricle where VT's can originate from: The left ventricle is depicted as having been opened. Regionsare as follows: '''AA''' = antero-apical; '''AB''' = antero-basal; '''AM''' = mid-anterior; '''SA''' = apical septum; '''SB''' = basal-septum; '''SM''' = mid-septum; '''PA''' = posterior apex; '''PB''' = postero-basal; '''PM''' = mid-posterior.. Adapted from Miller et al.<cite>Miller</cite>]]
 
 
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.


Using this approach and the algorithm on the right <cite>segal</cite>  the exit site can be estimated with reasonable accuracy (PPV around 70%).
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.
 
[[File:LBBB_VT_i.svg|thumb|left|300px|Localising the VT exit in LBBB VT with negative QRS complexes inferior]]
[[File:LBBB_VT_i.svg|thumb|left|300px|Localising the VT exit in LBBB VT with negative QRS complexes inferior]]
[[File:LBBB_VT_p.svg|thumb|none|300px|Localising the VT exit in LBBB VT with positive QRS complexes inferior]]
[[File:LBBB_VT_p.svg|thumb|none|300px|Localising the VT exit in LBBB VT with positive QRS complexes inferior]]