Negative Participation of the Left Posterior Fascicle in the Reentry Circuit of Verapamil-Sensitive Idiopathic Left Ventricular Tachycardia

Left Posterior Fascicle and Idiopathic Left VT. The left posterior fascicle may be a bystander of the circuit of verapamil-sensitive idiopathic left ventricular tachycardia. During ventricular tachycardia (VT), 3 sequences of potentials were seen at the left posterior septum: diastolic Purkinje potentials propagating from base to apex and presystolic left posterior fascicular potentials and systolic left ventricular (LV) myocardial potentials propagating in the reverse direction. Selective capture of the left posterior fascicle by the sinus beat did not affect the VT cycle length. Entrainment pacing revealed that the retrograde limb of the circuit was not the left posterior fascicle, but the LV myocardium. (J Cardiovasc Electrophysiol, Vol. 23, pp. 556-559, May 2012)