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Early Afterdepolarizations in a Patient with Idiopathic Monomorphic Right Ventricular Tachycardia
Authors:HIROSHI NAKAGAWA  JUNKO MUKAI  KENJI NAGATA  SHINJI KARAKAWA  YUKIKO TSUGHIOKA  MITSUNORI OKAMOTO  HIDEO MATSUURA  GORO KAJIYAMA  YUIGHIRO MATSUURA
Affiliation:First Department of Internal Medicine, Hiroshima University School of Medicine, Hiroshima, Japan;The First Department of Surgery, Hiroshima University School of Medicine, Hiroshima, Japan
Abstract:To identify the role of afterdepolarizations in the induction of idiopathic monomorphic right ventricular tachycardia (VT), monophasic action potentials (MAPs) were recorded in a patient with this type of VT. The VT had a left bundle branch block configuration and inferior axis, and originated in the right ventricular outflow tract (RVOT). MAPs were recorded with a contact electrode at the origin of the VT, as well as other ventricular sites. The VT was induced by the intravenous administration of isoproterenol and/or rapid ventricular pacing and was preceded by short-long-short sequences of RR intervals. Early afterdepolarizations (EADs) in MAPs were recorded at the origin of VT (RVOT), but not recorded at other ventricular sites. These data suggest that catecholamine sensitive triggered activity seems to be the mechanism of idiopathic monomorphic right VT and EADs can be recorded in association with the occurrence of this type of VT.
Keywords:idiopathic ventricular tachycardia    triggered activity    early afterdepolarizations    monophasic action potentials    isoprotereno
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