Successful elimination of recurrent ventricular tachycardia by epicardial ablation over coronary artery supplying postinfarction aneurysm  Kenichiro Yamagata,

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Presentation transcript:

Successful elimination of recurrent ventricular tachycardia by epicardial ablation over coronary artery supplying postinfarction aneurysm  Kenichiro Yamagata, MD, PhD, Petr Peichl, MD, PhD, Josef Kautzner, MD, PhD  HeartRhythm Case Reports  Volume 4, Issue 4, Pages 131-134 (April 2018) DOI: 10.1016/j.hrcr.2017.10.001 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Various modalities showing the left ventricle. A: A 12-lead electrocardiogram of the clinical ventricular tachycardia. B: Radiograph with a right anterior oblique (RAO) view showing calcification at the apex. C: Electroanatomical endocardial voltage map of the left ventricle with RAO view showing a scar area at the apex. D: Intracardiac echocardiography from the left ventricle (LV) cavity revealing a laminar thrombus at the apex (white arrowheads). E: Computed tomography angiography showing a thrombus beneath the calcified epicardium (white arrowheads). Ao = aorta; LA = left atrium. F: Electroanatomical epicardial voltage map showing a broad scar area at the apex. Electroanatomical map tag definition: gray = scar; red = ablation point; pink = fractionated potential. HeartRhythm Case Reports 2018 4, 131-134DOI: (10.1016/j.hrcr.2017.10.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Right coronary angiogram before and after radiofrequency ablation at the epicardium. A: Before radiofrequency application, the collateral artery via the septum branch to the distal left anterior descending artery was observed (black arrows). B: After radiofrequency (RF) energy was applied, the artery supplying blood to the apex was occluded (white arrows). The local electrogram at that site was unremarkable, showing low-amplitude, far-field signal. HeartRhythm Case Reports 2018 4, 131-134DOI: (10.1016/j.hrcr.2017.10.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions