Right Ventricular Outflow Tract Tachycardia with Structural Abnormalities of the Right Ventricle and Left Ventricular Diverticulum.
A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT). ECG showed a QRS in left bundle branch block morphology with inferior axis. Echocardiography, ventricular angiography, and cardiac magnetic resonance imaging (CMRI) revealed a normal right ventricle and a left ventricular diverticulum. Electrophysiology studies with epicardial voltage mapping identified a large fibrotic area in the inferolateral layer of the right ventricular wall and a small area of fibrotic tissue at the anterior right ventricular outflow tract. VT ablation was successfully performed with combined epicardial and endocardial approaches.
Cardiovascular Unit, Alto Vicentino Hospital, Via Gioberti 9, 36016 Thiene, Italy.
Bortolo
B
Martini
San Raffaele Hospital, 20132 Milan, Italy.
Nicola
N
Trevisi
Cardiovascular Unit, Alto Vicentino Hospital, Via Gioberti 9, 36016 Thiene, Italy ; Medical College, Ferrara Medical University, 44121 Ferrara, Italy.
Nicolò
N
Martini
Lankenau Medical Center, Wynnewood, PA 19096, USA ; Lankenau Institute for Medical Research, Wynnewood, PA 19096, USA ; Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Li
L
Zhang