Definition of the reentry circuit with demonstration of a low frequency diastolic potential in a patient with verapamil-sensitive idiopathic left ventricular tachycardia.

A low frequency slow potential preceding the Purkinje spike was recorded at the midseptum during tachycardia in a 69-year-old man with verapamil-sensitive left ventricular tachycardia. This potential was characteristically absent during sinus rhythm before radiofrequency ablation, but became evident following the QRS complex after successful ablation at the tachycardia exit site. Induction of tachycardia with programmed stimulation was dependent on emergence of this slow potential. Decremental conduction was noted between the QRS complex and the slow potential. Further energy application at a site proximal to where the slow potential was initially recorded totally eliminated the slow potential.