The mechanisms of ventricular tachycardia in humans determined by intraoperative recording of the electrical activation sequence

Jay W. Mason, Edward B. Stinson, Philip E. Oyer, Roger A. Winkle, Steven Hunt, Kelley P. Anderson, Geraldine C. Derby

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We recorded ventricular activation sequence during ventricular tachycardia in 76 patients who underwent surgical therapy of refractory ventricular tachycardia. Ventricular tachycardia arose from a discrete site (focal origination) in 28 patients (37%) or resulted from reentry around scar (macroreentry) in 22 patients (29%). The mechanism responsible for ventricular tachycardia was not discernable in the remaining 26 patients (34%), usually because of inadequacy of activation data. We conclude: (1) although focal originating of ventricular tachycardia is common, more frequently the mechanism is either macroreentry or uncertain, as assessed by conventional recording techniques; thus, a search for the "site of earliest activation" during ventricular tachycardia frequently may fail to direct rationally the operative procedure; (2) conventional techniques for intraoperative study of electrical activation during ventricular tachycardia are inadequate.

Original languageEnglish
Pages (from-to)163-172
Number of pages10
JournalInternational Journal of Cardiology
Issue number2
Publication statusPublished - Jun 1985



  • electrophysiology
  • ventricular activation
  • ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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