Ultra-low-temperature cryoablation for ventricular tachycardia in nonischemic cardiomyopathy—A case report

Figures

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  Figure 1. Twelve-lead electrocardiogram morphologies and intracardiac voltage map/CARTOUNIVU. A: Ventricular tachycardia (VT) with a basal superior exit. B: Comparable to (A), with presumably epicardial exit. C: Clinically documented VT with a suggestive septal exit. D: Right anterior oblique view during cryoablation. The catheter is placed at the septal aspect at the border zone of a low-voltage area, adjacent to a previous ablation at sides of the best-matching pace map for (C), surrogated by the pink location point. E: Left anterior oblique view. The basal superior pink location mark surrogates the best pace map for (B), which was later assessed during the procedure. CARTOUNIVU integrates fluroscopy imaging within the CARTO 3 System maps.

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  Figure 2. Right anterior oblique (top left) and left anterior oblique (top right) view at sides of the ventricular tachycardia exit; the catheter ex vivo (bottom).

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  Figure 3. Preprocedural and postprocedural cardiac magnetic resonance (CMR) imaging. A, B: Preprocedural CMR scan, 4-Chamber-View (4CHV) and Short-Axis-View (SAV): late gadolinium enhancement (LGE) demonstrating intramyocardial septal fibrosis. C, D: Postprocedural CMR scan, 4CHV and SAV: LGE can now be additionally demonstrated at the endocardial surface of the left ventricle at sides of catheter ablation. E, F: Postprocedural CMR scan, 4CHV and SAV: This sequence shows microvascular obstruction at the septal aspect of the interventricular septum, surrogating the direct cryothermal ablation effect.