Electroanatomical mapping-guided endocardial and epicardial ablation of sustained ventricular tachycardia originating from alcohol septal ablation-induced scar in a patient with hypertrophic obstructive cardiomyopathy

J Cardiovasc Electrophysiol. 2010 Nov;21(11):1296-9. doi: 10.1111/j.1540-8167.2010.01759.x.

Abstract

Ventricular Tachycardia After Alcohol Septal Ablation. A 76-year-old female developed 2 different ventricular tachycardias (VTs) 5 years after alcohol septal ablation (ASA) for symptomatic hypertrophic obstructive cardiomyopathy. VT#1 was a small macroreentry at the anterior border of the low-voltage zone, suggesting the ASA-scar and eliminated by endocardial ablation at a site recording fractionated potentials covering the mid-diastolic and presystolic periods. VT#2 was a focal VT and eliminated by epicardial cryoablation at the basal posterior left ventricle, suggesting the posterior border of the ASA-scar. Using the electroanatomical mapping, we demonstrated that the mechanism of the VTs was reentry at the edge of the ASA-scar.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Body Surface Potential Mapping / methods*
  • Cardiomyopathy, Hypertrophic / etiology*
  • Cicatrix / etiology*
  • Endocardium / surgery
  • Ethanol / adverse effects*
  • Female
  • Humans
  • Pericardium / surgery
  • Sclerosing Solutions / adverse effects
  • Surgery, Computer-Assisted / methods*
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / etiology*
  • Tachycardia, Ventricular / surgery*
  • Treatment Outcome

Substances

  • Sclerosing Solutions
  • Ethanol