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Identifying non-inducible ventricular tachycardia origin utilizing defibrillator electrograms.

Cory M Tschabrunn¹, Elad Anter, Francis E Marchlinski

¹Cardiac Electrophysiology Program, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing

|October 30, 2012

Summary

Utilizing implantable cardioverter-defibrillator (ICD) electrograms (EGMs) can guide ventricular tachycardia (VT) ablation when arrhythmias are not inducible. This strategy successfully treated a patient with VT storm, keeping them arrhythmia-free for 11 months.

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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

Area of Science:

Cardiology
Electrophysiology
Medical Devices

Background:

Inducing clinical arrhythmias for ablation is challenging.
Ventricular tachycardia (VT) storm necessitates effective ablation strategies.

Observation:

A 72-year-old male presented with ventricular tachycardia (VT) storm.
Endocardial and epicardial voltage mapping showed normal results.
Program stimulation failed to induce any arrhythmias.

Findings:

Implantable cardioverter-defibrillator (ICD) electrograms (EGMs) were recorded during pacing and compared to stored clinical events.
Ablation lesions were delivered to a specific area matching the ICD EGM pace maps.
The patient remained free of arrhythmias for 11 months post-ablation.

Implications:

ICD EGMs can be a valuable tool for VT ablation when clinical arrhythmias are not inducible.
This approach may improve success rates for VT ablation in challenging cases.
Pacing from ICDs offers an alternative mapping strategy in the EP lab.