Anatomy of a steam pop – Acute histopathology in human myocardium after ventricular tachycardia ablation

Figures

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  Figure 1. Three-dimensional electroanatomic maps of the endocardial left ventricle. A: Ventricular tachycardia (VT) activation map with corresponding intracardiac electrograms demonstrating a diastolic corridor in the anteroseptal region. Red and pink dots represent radiofrequency ablation lesions. B: Voltage map with corresponding intracardiac electrograms showing a gradient of late activation with multielectrode recordings.

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  Figure 2. Acute gross pathology and histopathology of human ventricular endocardium after radiofrequency ablation. A: Gross pathology of non–steam pop lesion with myocardial necrosis and peripheral hemorrhage (green dotted line and triangle) and steam pop lesion with coagulative necrosis and diffuse hemorrhage (blue dotted line and star). B: Microscopic analysis of the green area in panel A demonstrating myocardial necrosis with neutrophilic infiltration. C: Microscopic analysis of the blue area in panel A demonstrating coagulation necrosis, complete tissue destruction, and cellular dissolution. LV = left ventricle; RV = right ventricle.