Mapping and surgical ablation of focal epicardial left ventricular tachycardia.
We describe a technical challenge in a 17-year-old patient with incessant epicardial focal ventricular arrhythmia and diminished LV function. Failure of ablation at the earliest activated endocardial site during ectopy suggested an epicardial origin, which was supported by specific electrocardiographic criteria. Epicardial ablation was not possible due to the localization of the origin of the ventricular tachycardia adjacent to the phrenic nerve. Minimal invasive surgical multielectrode high-density epicardial mapping was performed to localize the arrhythmia focus. Epicardial surgical RF ablation resulted in the termination of ventricular ectopy. After 2 years, the patient is still free from arrhythmias.
Department of Cardiology, Isala Klinieken Zwolle, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
Arif
A
Elvan
Department of Cardiothoracic Surgery, Isala Klinieken Zwolle, 8011 JW Zwolle, The Netherlands.
Hauw T
HT
Sie
Department of Cardiology, Isala Klinieken Zwolle, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
Anand R
AR
Ramdat Misier
Department of Experimental Cardiology, Academic Medical Centre, 1105 AZ Amsterdam, The Netherlands.
Andre C
AC
Linnenbank
Department of Cardiology, Isala Klinieken Zwolle, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
Peter Paul H M
PP
Delnoy
Department of Experimental Cardiology, Academic Medical Centre, 1105 AZ Amsterdam, The Netherlands.
Jacques M T
JM
de Bakker