Ablation of an anatomical isthmus identified by preprocedural CT wall thinning data resulted in no VT inducibility and the absence of any VTs for 2 years in a patient with ischemic VT.
Case Report (n=1)
Does preprocedural CT-guided identification of anatomical channels improve ablation outcomes in a patient with ischemic ventricular tachycardia?
Preprocedural CT wall thinning data can identify anatomical channels to guide successful ablation of ischemic ventricular tachycardia.
We describe a 47-year-old woman with ischemic ventricular tachycardia (VT) with repetitive implantable cardioverter-defibrillator shocks, requiring ablation. Preprocedural computed tomography (CT) demonstrated a single anatomical channel on the inferior-basal infarcted area between less than a 3-mm wall-thinning area and the mitral annulus, which suggested the circuit of two VTs observed. In addition, distribution of less than 2 mm and less than 3 mm wall-thinning area can explain the mechanism of the variation of the QRS morphology and S-QRS interval during entrainment. Ablation in this region resulted in no VT inducibility and the absence of any VTs for 2 years. CT wall thinning data may allow us to understand the mechanism and circuit of VT and aid VT ablation procedures.
Takigawa et al. (Sat,) conducted a case report in Ischemic ventricular tachycardia (n=1). Ablation guided by preprocedural computed tomography (CT) was evaluated on VT inducibility and recurrence. Ablation of an anatomical isthmus identified by preprocedural CT wall thinning data resulted in no VT inducibility and the absence of any VTs for 2 years in a patient with ischemic VT.