title: Histopathological verification for successful ablation of mitral isthmus ventricular tachycardia complicated with cardiac sarcoidosis.
abstract: A 68-year-old man died a few days after catheter ablation of drug-resistant, monomorphic ventricular tachycardia (VT) complicated with cardiac sarcoidosis. The diagnosis of mitral isthmus VT was made from electrophysiological observations, including electro-anatomical activation and voltage map, pace-mapping, entrainment mapping and ablation outcome. On autopsy of the heart, sarcoidic lesion with scattered fibrous tissue in the mitral isthmus was non-transmural, and the surviving myocardium serving as the reentry circuit in the endomyocardium was isolated from the adjacent viable epimyocardium, enabling the sustenance of macroreentry across the mitral isthmus. Non-transmural lesions produced by RF delivery created a barrier sufficient to interrupt the myocardial bundles located in the mitral isthmus, eliminating the mitral isthmus VT.
authors.affiliation: Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Japan. kanekoy@gunma-u.ac.jp
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Osamu
authors.initials: O
authors.lastname: Igawa
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Irie
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Adachi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yokoo
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nakazato
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
mesh_terms: D000368:Aged; D009202:Cardiomyopathies / Q000150:complications / Q000473:pathology*; D017115:Catheter Ablation / Q000379:methods; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000473:pathology*; D012507:Sarcoidosis / Q000150:complications / Q000473:pathology*; D017180:Tachycardia, Ventricular / Q000150:complications / Q000473:pathology*