Epicardial macro-reentrant ventricular tachycardia exhibiting an endocardial centrifugal activation pattern in a case with arrhythmogenic right ventricular cardiomyopathy.
Macro-Reentrant ARVC epi-VT with a Focal Endo-Activation. A 55-year-old man with arrhythmogenic right ventricular cardiomyopathy underwent catheter ablation of ventricular tachycardia (VT) with left bundle branch block and left superior axis QRS morphology with an early precordial transition. Endocardial mapping during the VT revealed a focal activation pattern from a small region of low voltage in the left ventricular (LV) septum. Despite earliest endocardial activation in the LV septum, epicardial mapping demonstrated a macro-reentrant circuit with successful catheter ablation at an inferior peritricuspid annular site. Activation from the reentrant circuit propagated through the scar area in the epicardial right ventricle to the remote endocardial LV breakout site.
Yamada
Takumi
T
Division of Cardiovascular Disease, University of Alabama at Birmingham, 1670 University Boulevard, 1530 3rd Avenue S, Birmingham, AL 35294-0019,USA. takumi-y@fb4.so-net.ne.jp
Plumb
Vance J
VJ
Tabereaux
Paul B
PB
Kay
G Neal
GN
D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*