Radiofrequency catheter ablation of ventricular tachycardia in right ventricular cardiomyopathy: use of concealed entrainment to identify the slow conduction isthmus bounded by an aneurysm and the tricuspid annulus.
Radiofrequency (RF) catheter ablation of ventricular tachycardia (VT) in patients with a right ventricular (RV) cardiomyopathy has only rarely been successful. This report demonstrates reentrant VT in the setting of RV cardiomyopathy in which the tricuspid valve annulus acted as one of the barriers of an isthmus of slow conduction, identified by the presence of entrainment with concealed fusion. The RF pulse was further targeted by analysis of the relationship between the postpacing interval with the tachycardia cycle length, and of the local activation time with the stimulation time. Long-term clinical follow-up has documented no recurrent VT.
Stark
S I
SI
Department of Electrophysiology, Mercy General Hospital, Sacramento, California, USA.
Arthur
A
A
Lesh
M D
MD
D009202:Cardiomyopathies / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017115:Catheter Ablation; D004562:Electrocardiography; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology