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- W4377015827 abstract "When ventricular tachycardia (VT) continues after entrainment the post pacing interval (PPI) can be used to assess proximity to the circuit. It is not known if the initial beats of a pacing train can be used to assess reentry circuit proximity, which could be useful when pacing terminates or alters VT. We hypothesized that the number of stimuli with local electrogram(EGM) capture needed to reset (NNR) VT may provide an indication of proximity to the reentry circuit as has been shown in atrial flutter. During stable scar-related VT, pacing trains 10 – 40ms faster than the VT cycle length with the first stimulus synchronized to a ventricular electrogram were delivered. We included sites with stable VT cycle length(TCL) and without perturbation of VT post pacing to allow comparison with the PPI-TCL. Of 102 trains at 92 sites in 28 VTs in 17 patients the first capturing stimulus was earlier than 30 ms in prematurity relative to local activation, such that NNR could be artificially short. NNR was analyzed in the remaining 23 trains at 21sites in 10 VTs (457ms +/- 85ms CL). The PPI-TCL ranged from 0-100ms and the NNR ranged from 1-6. PPI-TCL was correlated with NNR (r=0.67, p=0.006) (figure). When the first or second stimulus reset VT (NNR = 1 or 2) the PPI-TCL was < 30ms and 3-6 with a PPI-TCL of >30ms. The NNR provides an indication to the proximity to the circuit with NNR <2 indicating a PPI-TCL of <30ms that can potentially be applied if pacing terminates VT. Application of NNR requires attention to synchronization of the pacing train that is not straight forward in areas of fractionated electrograms." @default.
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- W4377015827 date "2023-05-01" @default.
- W4377015827 modified "2023-10-01" @default.
- W4377015827 title "PO-04-186 ASSESSING PROXIMITY TO THE VENTRICULAR TACHYCARDIA CIRCUIT EARLY IN THE PACING TRAIN: NUMBER NEEDED TO RESET" @default.
- W4377015827 doi "https://doi.org/10.1016/j.hrthm.2023.03.1202" @default.
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