Segmental conduction block in a low-voltage area suppressed macro-reentrant ventricular tachycardia after surgical repair of tetralogy of Fallot.
Macro-reentrant ventricular tachycardia (VT) developed in a 20-year-old man, 17 years after surgical repair of tetralogy of Fallot. Activation mapping of the VT revealed its counterclockwise propagation around the right ventricle, and through a critical pathway between a transannular patch and the tricuspid annulus. This critical pathway was 6 cm long and contained myocardium with a normal amplitude, while the area of low voltage was limited adjacent to the transannular patch. A linear lesion was created by radiofrequency energy delivered only to the low voltage area. After ablation, the activation wavefront through the low voltage area was blocked, and VT became non-inducible.
Chinushi
Masaomi
M
School of Health Science, Niigata University School of Medicine. masaomi@clg.niigata-u.ac.jp
Komura
Satoru
S
Furushima
Hiroshi
H
Aizawa
Yoshifusa
Y
D000328:Adult; D054537:Atrioventricular Block / Q000503:physiopathology*; D017115:Catheter Ablation; D017147:Defibrillators, Implantable; D006801:Humans; D008297:Male; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D013771:Tetralogy of Fallot / Q000601:surgery*