title: Reentrant ventricular outflow tract tachycardia arising from focal scar detected by delayed enhancement magnetic resonance imaging.
abstract: A 58-year-old man was referred to our emergency room with hemodynamically unstable sustained ventricular tachycardia (VT). The morphology of the VT exhibited a left bundle branch block and inferior axis deviation. He had no past history of cardiovascular disease. Echocardiography, cardiac catheterization, cardiac biopsy, gallium scintigram, myocardial scintigram, T1,T2-weighted magnetic resonance imaging (MRI), and gadolinium-enhanced cine MRI did not detect any structural heart disease or abnormal cardiac function. However, delayed-enhancement MRI (DE-MRI) detected a focal intramural scar within the septal ventricular outflow tract. An electrophysiological study revealed a sustained VT with several morphologies and the entrainment phenomenon. Radiofrequency catheter ablation to the site corresponding to the focal scar detected by DE-MRI successfully eliminated the VT.
authors.affiliation: Division of Cardiology, Sendai City Hospital, Sendai, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yamashina
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Yagi
authors.forename: Akio
authors.initials: A
authors.lastname: Namekawa
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ishida
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Sato
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Manjirou
authors.initials: M
authors.lastname: Sakuramoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Sato
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yambe
mesh_terms: D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation; D002921:Cicatrix / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery