Role of epicardial mapping in catheter ablation of postmyocardial infarction ventricular tachycardia

Citation
F. Santoni-rugiu et al., Role of epicardial mapping in catheter ablation of postmyocardial infarction ventricular tachycardia, J INTERV CA, 13(2), 2000, pp. 129-135
Citations number
14
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
JOURNAL OF INTERVENTIONAL CARDIOLOGY
ISSN journal
0896-4327 → ACNP
Volume
13
Issue
2
Year of publication
2000
Pages
129 - 135
Database
ISI
SICI code
0896-4327(200004)13:2<129:ROEMIC>2.0.ZU;2-B
Abstract
The role of epicardial mapping for radiofrequency (RF) catheter ablation of postmyocardial infarction monomorphic ventricular tachycardia (VT) is stil l under investigation We present two septuagenarian patients with a history of myocardial infarction, poor left ventricular function, and drug-refract ory nonomorphic VT who were treated with RF catheter ablation. The first pa tient had a history of myocardial infarction, left ventricular aneurysm, an d mitral valve replacement complicated by recurrent drug refractory VT and congestive heart failure. The second patient had ischemic cardiomyopathy an d VT and was implanted with a cardioverter defibrillator and subsequently s uffered repeated episodes of VT refractory to multiple antiarrhythmic drugs . In both patients, coronary sinus mapping was performed with a multipolar catheter as endocardial mapping did not reveal satisfactory sites for ablat ion. Epicardial catheter mapping provided stable electrograms and identific ation of areas of slow conduction during VT. RF lesions guided by epicardia l mapping resulted in successful ablation of VT and no recurrence at long-t erm follow-up. This report emphasizes the potential usefulness of coronary sinus mapping as an adjuvant to endocardial mapping to guide VT ablation.