Objective  To investigate whether taking diastolic potential (DP) and earliest Purkinje potential (PP) as ablation targets together is superior to taking earliest PP alone in patients with left posterior fascicular ventricular tachycardia (VT).   Methods  Totally 18 patients who were admitted in our department from May 2006 to May 2009 were enrolled

and the results of their electrophysiological examination were analyzed. According to radiofrequency (RF) ablation targets

patients were classified into 2 groups: DP+PP group (DP and PP as ablation targets together) and PP group (PP as the target alone). Successful RF ablation was established when the ventricular tachycardia was no longer inducible. The acute success rate

recurrent rate

number of ablation application

procedure time

X-ray exposure and complications were compared between DP+PP and PP groups.   Results  There was 1 case receiving no ablation because of not being induced to clinical VT. Seventeen cases were induced to clinical VT and displayed right bundle branch block (RBBB) and left axis morphology (DP+PP group 7 cases

and PP group 10 cases). All cases were successfully ablated

their DP-Q interval and PP-Q interval were 60.17±8.16 and 30.64±7.19 ms

respectively. There was no significant difference between the 2 groups in the age

ventricular tachycardial cycle

procedure time and recurrent rate. Compared to the PP group

the number of RF application in DP+PP group was fewer (4.55±2.07 vs 7.50±1.64

P=0.04)

and X- ray exposure time was a little longer (18.33±1.51 min vs 15.37±2.77 min

P=0.03). There was neither left posterior fascicular block nor other complications seen in the 2 groups. The follow-up period was 14.29±10.05 months

and during this there was 1 case recurrence in DP group (2 months after procedure) and 1 case in PP group (1 month after procedure) respectively.   Conclusion  The 2 methods are effective and safe for successful ablation of left posterior fascicular VT. Compared to ablation of earliest PP site alone

ablation of DP+PP might need fewer times of RF application but longer X-ray exposure time.