[Surgical resection of a focus of ventricular tachycardia guided by endocardial and epicardial mapping].
We describe a case of a 46 years old female with chagasic heart disease. In one year she presented six episodes of sustained ventricular tachycardia, heart rate 230 beats per minute, morphology of RBBB AQRS -60 degrees, with hemodynamic deterioration that needed electrical cardioversion. She was treated with several antiarrhythmic drugs but not good response was obtained. Programmed electrical stimulation was done and it show three different types of ventricular tachycardia, trough pace-mapping the site of the clinical tachycardia was located in the portion inferior and inferior-posterior of the left ventricle that was confirmed by entrainment. Epicardial mapping was performed in 38 ventricular sites following the modified Harken sketch and the location of the site of outlet was confirmed in the posterior base of the left ventricle, at this point the surgical resection was done with no complication. The results were satisfactory. Eight days later programmed electrical stimulation was done and the ventricular tachycardia could not be induced. Six months afterwards the patient is asymptomatic without medical treatment.
Iturralde
P
P
Departamento de Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Barragán
R
R
Araya
V
V
Romero
L
L
Ramírez
S
S
Colín
L
L
Kershenovich
S
S
Molina
J
J
González-Hermosillo
J A
JA
D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D004594:Electrophysiology; D004699:Endocardium; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008875:Middle Aged; D010496:Pericardium; D013610:Tachycardia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*
Resección quirúrgica de un foco de taquicardia ventricular, guiada por mapeo endocárdico y epicárdico.