The Application of Holter ECG-Based T-Wave Alternans in Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy

Ventricular arrhythmias (VAs) originating from parahisian (PH) area has not been fully understood. This study was to investigate the electrocardiographic and electrophysiologic characteristics and results of Catheter ablation (CA) of VAs originating from PH area. Methods: Among 302 consecutive patients who underwent CA for ventricular tachycardia (VT) or symptomatic premature ventricular complexes (PVCs), 6 patients (2.0%, 43 ±8 years) were found to have successful CA site at PH area. Results: All but one patient had normal LV systolic function. Mean QRS width of VT/PVC was 114.3±19.9ms, which was narrower than other sites (147.0 ±15.3ms, P=0.008), inferior axis in 5 patients, positive in aVL in 4 patients, and right (RBBB) in 2 and left bundle branch block (LBBB) in 4. VT was inducible by programmed ventricular stimulation in Purpose: Previous study reported the voltage of local bipolar electrogram in the healthy region of the ventricle was larger than 1.5mV, damaged region was less than 1.5mV, and scar region was less than 0.5mV. The aim of this study was to assess the voltage of the local bipolar electrogram of the channel. Methods: 36 consecutive patients underwent radiofrequency ablation because of sustained monomorphic OMI-VT were studied. Electroanatomical mapping was performed during VT if VT was hemodynamically tolerable (VT mapping) and during sinus rhythm (SR) if non-tolerable (SR mapping). Definition of the channel was following.