[Radiofrequency ablation in idiopathic ventricular tachycardia originating in the right ventricle]

We present the case of a 10-year-old boy, with structurally normal heart who began two years before admission, with sustained monomorphic ventricular tachycardia with heart rate of 280 bpm and LBBB morphology, AQRS + 60 degrees, with pallor and diaphoresis. The tachycardia was treated with xylocain. He was also treated with propaphenone, verapamil, and amiodarona, in spite of these, he continued with this type of arrhythmia 2 or 3 times a month. We performed an electrophysiologic study which showed ventricular tachycardia originated in the right ventricle infundibulum. We took an endomyocardial biopsy, which was normal. He was scheduled for percutaneous catheter ablation of the tachycardia by radiofrequency energy. During the procedure the ventricular tachycardia appeared spontaneously, we mapped the most early ventricular activation and then in sinus rhythm, this site was pace mapped and resulted in similar pattern of clinical ventricular tachycardia. We identified the site of origin of the ventricular tachycardia in the posterior region of the right ventricle infundibulum, delivering radiofrequency, changing to sinus rhythm. Then we paced the apex of the right ventricle without inducing any form of arrhythmia. He is asymptomatic four months later.