Mitral isthmus pathology of re-entrant ventricular tachycardia in a patient with idiopathic dilated cardiomyopathy.
A 68-year-old woman with idiopathic dilated cardiomyopathy suffered from drug-resistant monomorphic ventricular tachycardia (VT). Electrophysiological study revealed a re-entrant VT circuit located just beneath the inferior mitral valve annulus. The VT was considered to be related to the mitral valve isthmus and was abolished by radiofrequency ablation. The patient died 2 years after the ablation due to worsening of heart failure and an autopsy was performed. Pathological examination revealed ablation scar tissue on the localized myocardial bundle running parallel to the mitral valve annulus. Therefore, this bundle appeared to comprise the slow conduction area of the re-entrant VT in this case.
Matsuyama
Taka-aki
TA
Department of Pathology, National Cardiovascular Center, 5-7-1 Fujishirodai Suita-City, Osaka 565-8565, Japan. takamatu@hsp.ncvc.go.jp
Kurita
Takashi
T
Suyama
Kazuhiro
K
Okamura
Hideo
H
Noda
Takashi
T
Satomi
Kazuhiro
K
Shimizu
Wataru
W
Aihara
Naohiko
N
Ikeda
Yoshihiko
Y
Inoue
Shin
S
Kamakura
Shiro
S
Ishibashi-Ueda
Hatsue
H
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D016896:Treatment Outcome