Epicardial macroreentrant ventricular tachycardia associated with a left ventricular aneurysm
Takumi Yamada1, Harish Doppalapudi, H Thomas McElderry
1Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama 5294-0019, USA. takumi-y@fb4.so-net.ne.jp
Abstract:
A 62-year-old man with severe coronary artery disease and a left ventricular aneurysm underwent catheter ablation of ventricular tachycardia (VT) with right bundle branch block QRS morphology. Endocardial bipolar voltage mapping with standard threshold settings demonstrated no low-voltage areas within the aneurysm. Catheter ablation of the epicardial surface of the aneurysm eliminated the VT. Endocardial bipolar voltage mapping with any other settings could not predict the site of the epicardial arrhythmogenic substrate whereas endocardial unipolar voltage mapping could. Endocardial unipolar voltage mapping may be helpful for predicting epicardial arrhythmogenic substrates.
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