Catheter Ablation of Incessant Ventricular Tachycardia in a Patient With Coronary Artery Disease

Abstract

A 67-year-old male with known coronary artery disease was referred to our hospital for catheter ablation of incessant ventricular tachycardia (VT). Transthoracic echocardiography revealed severe wall motion abnormalities of the left ventricle along with an apical aneurysm. Left ventricular voltage mapping showed a region with low voltage (<1.5 mV) at the left ventricular apex. Propagation mapping revealed a macro-reentry circuit around the apical aneurysm. Mid-diastolic potentials were recorded during the VT (Fig. 1, left panel, arrows), while entrainment mapping was excellent. The first radiofrequency energy application terminated the tachycardia. A circumferential lesion around the aneurysm was finally performed (Fig. 1, right panel, red dots). Ventricular tachycardia became non-inducible, and the patient is free from arrhythmic events during the last six months... (excerpt)