Identification of an epicardial slow conduction channel using ripple mapping in ablation of postinfarct ventricular tachycardia

J Cardiovasc Electrophysiol. 2019 Jul;30(7):1156-1158. doi: 10.1111/jce.13955. Epub 2019 Jun 5.

Abstract

An 82-year-old man underwent redo catheter ablation of ventricular tachycardia (VT) after anterior infarction. A ripple mapping conducting channel (RMCC) was identified within the anterior scar in the left ventricular epicardium during sinus rhythm. Along the RMCC, delayed potentials during sinus rhythm, a good pace map with a long stimulus to the QRS interval, and mid-diastolic potentials during VT were recorded, and epicardial ablation at this site eliminated the VT. These findings suggested that the RMCC in the epicardial scar served as a critical isthmus of the postinfarct VT, and ablation targeting the RMCC was effective.

Keywords: catheter ablation; epicardial; mapping; myocardial infarction; ventricular tachycardia.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Action Potentials
  • Aged, 80 and over
  • Anterior Wall Myocardial Infarction / complications*
  • Anterior Wall Myocardial Infarction / diagnosis
  • Anterior Wall Myocardial Infarction / physiopathology
  • Catheter Ablation*
  • Electrocardiography
  • Electrophysiologic Techniques, Cardiac*
  • Heart Rate
  • Humans
  • Male
  • Pericardium / physiopathology
  • Pericardium / surgery*
  • Predictive Value of Tests
  • Recurrence
  • Reoperation
  • Tachycardia, Ventricular / diagnosis
  • Tachycardia, Ventricular / etiology
  • Tachycardia, Ventricular / physiopathology
  • Tachycardia, Ventricular / surgery*
  • Treatment Outcome