Ultra-High Density Mapping of Ventricular Tachycardia in a Patient With Arrhythmogenic Right Ventricular...

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy that often leads to ventricular dysfunction and recurrent ventricular tachycardia (VT). Catheter ablation is a beneficial treatment for ARVC-related VT, but extensive substrate ablation may increase the risk of iatrogenic hemodynamic decompensation.

We describe a 54-year-old female ARVC patient with paroxysmal palpitations and frequent implantable cardioverter-defibrillator discharges.

This case demonstrates that ultra-high density mapping-guided precise ablation can effectively target the "culprit" substrate in ARVC patients with extensive ventricular scarring, achieving a favorable balance between long-term freedom from VT and preservation of residual cardiac function.

Precise ablation balances efficacy and safety by ensuring long-term VT freedom and preserving residual cardiac function in ARVC patients. Comprehensive mapping techniques, including activation mapping, entrainment mapping, and isochronal late activation mapping, improve ablation accuracy.