Electroanatomical mapping-guided endocardial and epicardial ablation of sustained ventricular tachycardia originating from alcohol septal ablation-induced scar in a patient with hypertrophic obstructive cardiomyopathy.
Ventricular Tachycardia After Alcohol Septal Ablation. A 76-year-old female developed 2 different ventricular tachycardias (VTs) 5 years after alcohol septal ablation (ASA) for symptomatic hypertrophic obstructive cardiomyopathy. VT#1 was a small macroreentry at the anterior border of the low-voltage zone, suggesting the ASA-scar and eliminated by endocardial ablation at a site recording fractionated potentials covering the mid-diastolic and presystolic periods. VT#2 was a focal VT and eliminated by epicardial cryoablation at the basal posterior left ventricle, suggesting the posterior border of the ASA-scar. Using the electroanatomical mapping, we demonstrated that the mechanism of the VTs was reentry at the edge of the ASA-scar.
Murata
Hiroshige
H
Division of Cardiology, Department of Internal Medicine, Nippon Medical School, Japan. s7086@nms.ac.jp
Miyauchi
Yasushi
Y
Nitta
Takashi
T
Mizuno
Kyoichi
K
D000368:Aged; D018780:Body Surface Potential Mapping / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000209:etiology*; D002921:Cicatrix / Q000209:etiology*; D004699:Endocardium / Q000601:surgery; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010496:Pericardium / Q000601:surgery; D012597:Sclerosing Solutions / Q000009:adverse effects; D025321:Surgery, Computer-Assisted / Q000379:methods*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome
D012597:Sclerosing Solutions; D000431:Ethanol