Radiofrequency catheter ablation guided by noncontact mapping of ventricular tachycardia originating from an idiopathic left ventricular aneurysm

Matteo Santamaria, Manuela Cireddu, Stefania Riva, Nicola Trevisi, Paolo Della Bella

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Idiopathic left ventricular aneurysm and diverticulum is known to be an arrhythmogenic substrate associated to ventricular tachyarrhythmias, generally based on a reentry mechanism. A case of a young woman affected by a monomorphic ventricular tachycardia, refractory to medical treatment, originating from an aneurysm of the membranous interventricular septum is reported. The left ventricular aneurysm was well characterized by multislice computed tomography and left ventricular angiography. Because of the nonsustained and poorly tolerated nature of the target arrhythmia, a noncontact mapping system was used to guide radiofrequency catheter ablation, allowing the elaboration of a three-dimensional activation map of the left ventricle on the basis of a ventricular tachycardia single beat. The procedure was acutely successful, and the patient remained free of ventricular tachycardia recurrences without antiarrhythmic drugs during a subsequent 6-month follow-up period. This is the first report of a successful radiofrequency catheter ablation guided by noncontact mapping system of a ventricular tachycardia originating from an idiopathic left ventricular aneurysm. This nonfluoroscopic mapping method allows a reliable reconstruction of the spatial relationships between the left ventricular main cavity and the aneurysm and can be safely and effectively used to map the ventricular tachycardia and guide the ablation procedure, particularly when conventional mapping is not indicated or not effective because of nonsustained or not-tolerated characters of ventricular tachycardia.

Original languageEnglish
Pages (from-to)49-53
Number of pages5
JournalJournal of Interventional Cardiac Electrophysiology
Volume19
Issue number1
DOIs
Publication statusPublished - Jun 2007

Fingerprint

Catheter Ablation
Ventricular Tachycardia
Aneurysm
Multidetector Computed Tomography
Anti-Arrhythmia Agents
Diverticulum
Tachycardia
Heart Ventricles
Cardiac Arrhythmias
Angiography
Recurrence

Keywords

  • Idiopathic left ventricular aneurysm
  • Multislice computed tomography
  • Noncontact mapping
  • Radiofrequency catheter ablation
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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abstract = "Idiopathic left ventricular aneurysm and diverticulum is known to be an arrhythmogenic substrate associated to ventricular tachyarrhythmias, generally based on a reentry mechanism. A case of a young woman affected by a monomorphic ventricular tachycardia, refractory to medical treatment, originating from an aneurysm of the membranous interventricular septum is reported. The left ventricular aneurysm was well characterized by multislice computed tomography and left ventricular angiography. Because of the nonsustained and poorly tolerated nature of the target arrhythmia, a noncontact mapping system was used to guide radiofrequency catheter ablation, allowing the elaboration of a three-dimensional activation map of the left ventricle on the basis of a ventricular tachycardia single beat. The procedure was acutely successful, and the patient remained free of ventricular tachycardia recurrences without antiarrhythmic drugs during a subsequent 6-month follow-up period. This is the first report of a successful radiofrequency catheter ablation guided by noncontact mapping system of a ventricular tachycardia originating from an idiopathic left ventricular aneurysm. This nonfluoroscopic mapping method allows a reliable reconstruction of the spatial relationships between the left ventricular main cavity and the aneurysm and can be safely and effectively used to map the ventricular tachycardia and guide the ablation procedure, particularly when conventional mapping is not indicated or not effective because of nonsustained or not-tolerated characters of ventricular tachycardia.",
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AU - Cireddu, Manuela

AU - Riva, Stefania

AU - Trevisi, Nicola

AU - Della Bella, Paolo

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AB - Idiopathic left ventricular aneurysm and diverticulum is known to be an arrhythmogenic substrate associated to ventricular tachyarrhythmias, generally based on a reentry mechanism. A case of a young woman affected by a monomorphic ventricular tachycardia, refractory to medical treatment, originating from an aneurysm of the membranous interventricular septum is reported. The left ventricular aneurysm was well characterized by multislice computed tomography and left ventricular angiography. Because of the nonsustained and poorly tolerated nature of the target arrhythmia, a noncontact mapping system was used to guide radiofrequency catheter ablation, allowing the elaboration of a three-dimensional activation map of the left ventricle on the basis of a ventricular tachycardia single beat. The procedure was acutely successful, and the patient remained free of ventricular tachycardia recurrences without antiarrhythmic drugs during a subsequent 6-month follow-up period. This is the first report of a successful radiofrequency catheter ablation guided by noncontact mapping system of a ventricular tachycardia originating from an idiopathic left ventricular aneurysm. This nonfluoroscopic mapping method allows a reliable reconstruction of the spatial relationships between the left ventricular main cavity and the aneurysm and can be safely and effectively used to map the ventricular tachycardia and guide the ablation procedure, particularly when conventional mapping is not indicated or not effective because of nonsustained or not-tolerated characters of ventricular tachycardia.

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