title: Ablation of epicardial macroreentrant ventricular tachycardia associated with idiopathic nonischemic dilated cardiomyopathy by a percutaneous transthoracic approach.
abstract: Characterization of the substrate and mechanism of epicardial ventricular tachycardia (VT) associated with idiopathic nonischemic dilated cardiomyopathy is limited. We report a case of successful mapping and ablation of an epicardial VT by a percutaneous transthoracic approach in a patient with idiopathic dilated cardiomyopathy, frequent VT, and previously unsuccessful endocardial ablation. Evidence of myocardial scar was limited to the epicardium. Electroanatomic and entrainment mapping defined a figure-of-eight macroreentrant circuit within the epicardial scar. VT terminated at the onset of low-power radiofrequency application to the central isthmus of the circuit. VT was no longer induced and did not recur during long-term follow-up.
authors.affiliation: Loyola University Medical Center, Maywood, Illinois 60153, USA.
authors.forename: Vijendra
authors.initials: V
authors.lastname: Swarup
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Morton
authors.forename: Mauricio
authors.initials: M
authors.lastname: Arruda
authors.forename: David J
authors.initials: DJ
authors.lastname: Wilber
mesh_terms: D018780:Body Surface Potential Mapping; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D017115:Catheter Ablation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000503:physiopathology*; D019233:Retreatment; D017180:Tachycardia, Ventricular / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D017211:Treatment Failure