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.
Department of Pathology, National Cardiovascular Center, 5-7-1 Fujishirodai Suita-City, Osaka 565-8565, Japan. takamatu@hsp.ncvc.go.jp
Taka-aki
TA
Matsuyama
Takashi
T
Kurita
Kazuhiro
K
Suyama
Hideo
H
Okamura
Takashi
T
Noda
Kazuhiro
K
Satomi
Wataru
W
Shimizu
Naohiko
N
Aihara
Yoshihiko
Y
Ikeda
Shin
S
Inoue
Shiro
S
Kamakura
Hatsue
H
Ishibashi-Ueda
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