ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2025
In vivo mapping of human polymorphic ventricular tachycardia.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPolymorphic ventricular tachycardia (PMVT) is characterized by a typical change in QRS morphology and amplitude. This study aims to evaluate human PMVT mechanisms through in vivo ECG imaging (ECGI) mapping in patients with a normal QTc.
methodsAll patients from UZ Brussel and CHU Bordeaux were screened. The inclusion criterion for the study was PMVT mapped with ECGI. Exclusion criteria were as follows: (1) long QT, (2) premature ventricular contractions inducing PMVT, and (3) acute ischemia. Phase mapping was performed for each PMVT episode, and rotational and focal activity was adjudicated.
resultsA total of five patients were analyzed, and five episodes of PMVT were mapped. PMVT duration was 5.9 s, and the cycle length was 242.4 ms. The mean number of rotational activities was 2.5 ± 1.2, with a mean of 2.9 rotations on the apex. The mean number of focal activities was 1.4 ± 0.9. PMVT mechanism was consistent with the following. In the first phase of PMVT, a stable rotor was found over the ventricular apex. The reduction of QRS amplitude in PMVT was associated with the appearance of a non-apical activity. The further reduction of QRS amplitude (trough or minimum) was secondary to a fusion between the apical wavefront and the non-apical wavefront. In the second phase of PMVT, a stable rotational or focal activity was found.
conclusionThe main mechanism of human PMVT maintenance was rotational activity over the ventricular apex. Changes in QRS morphology and amplitude were secondary to a fusion between apical and non-apical activities.
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