Two mechanisms of termination of idiopathic reentrant ventricular tachycardia originating from the left coronary cusp/right coronary cusp commissure with.

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Two mechanisms of termination of idiopathic reentrant ventricular tachycardia originating from the left coronary cusp/right coronary cusp commissure with nonglobal capture Takekuni Hayashi, MD, Takeshi Mitsuhashi, MD, PhD, Yoshitaka Sugawara, MD, Shin-ichi Momomura, MD, PhD HeartRhythm Case Reports Volume 1, Issue 1, Pages 2-5 (January 2015) DOI: 10.1016/j.hrcr.2014.09.001 Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 1 A: Twelve-lead ECG showing constant fusion during right ventricular apex (RVA) overdrive pacing (cycle length [CL] = 360 ms) of the ventricular tachycardia (VT; CL = 370 ms). B: ECG showing progressive fusion during RVA overdrive pacing (CL = 340 ms) of the VT. HeartRhythm Case Reports 2015 1, 2-5DOI: (10.1016/j.hrcr.2014.09.001) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 2 A: Intracardiac electrogram showing overdrive pacing from the LCC/RCC commissure during ventricular tachycardia (cycle length = 360 ms) at a paced cycle length of 340 ms. B: Catheter position under fluoroscopy. C: Catheter position under intracardiac ultrasonography (Soundstar, Biosense Webster, Diamond Bar, CA). The tip of the ablation catheter is positioned in the LCC/RCC commissure. ABL = ablation catheter; CS = coronary sinus; HB = His bundle; LAO = left anterior oblique; LCC = left coronary cusp; NCC = noncoronary cusp; RCC = right coronary cusp; RVOT = right ventricular outflow tract; US = ultrasonography. HeartRhythm Case Reports 2015 1, 2-5DOI: (10.1016/j.hrcr.2014.09.001) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 3 Intracardiac electrogram showing that the single extrastimulus terminated the ventricular tachycardia (VT). A potential in the mid-diastolic phase during the VT is observed that persisted even after the VT terminated. However, this mid-diastolic potential more likely is a mechanical valve artifact as a result of a tiny potential, such as the mid-diastolic potential recorded, after the last QRS complex (asterisk). HeartRhythm Case Reports 2015 1, 2-5DOI: (10.1016/j.hrcr.2014.09.001) Copyright © 2015 Heart Rhythm Society Terms and Conditions