Monomorphic ventricular tachycardia related to Wolff-Parkinson-White surgery.
Monomorphic ventricular tachycardia (MVT) is well described in patients who have had a ventricular scar due to repair of congenital heart disease. A 54-year-old woman presented with MVT 20 years after WPW surgery for a left-sided accessory pathway. The circuit was mapped to an area at the base of the left ventricle consistent with the incision described in the operation report. Entrainment confirmed the re-entrant circuit. Successful radiofrequency ablation was performed in a zone of slowed conduction consistent with the circuit isthmus. Any iatrogenic ventricular scar may form the substrate for MVT and be treated with standard electrophysiology techniques.
Hillock
R J
RJ
Department of Cardiology, The Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne 3052, Australia. richard.hillock@mh.org.au
Roberts-Thomson
K C
KC
McGavigan
A D
AD
Kalman
J M
JM
D017115:Catheter Ablation; D002921:Cicatrix / Q000150:complications; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000601:surgery*; D014927:Wolff-Parkinson-White Syndrome / Q000601:surgery