Key result
Epicardial ablation prevents recurrent VT for at least two years in an ICM patient.
Why the study?
Endocardial reentry has traditionally been the mechanistic paradigm for ischemic cardiomyopathy VT, but recognition is growing that epicardial myocardium is also a critical substrate component.
Case Report (n=1)
No
Highlights that epicardial myocardium can be a critical component for VT substrate in ischemic cardiomyopathy, demonstrating a three-dimensional reentry circuit.
May support epicardial access in refractory ischemic VT; hypothesis-generating for substrate mapping.
In ischemic cardiomyopathy, endocardial reentry has traditionally been the mechanistic paradigm for understanding ventricular tachycardia (VT). However, recognition is growing that epicardial myocardium is a critical component for VT substrate, even in patients with ischemic cardiomyopathy. In this report, we present a novel case of a three-dimensional VT reentry involving epicardial components and an endocardial exit.
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Kotake et al. (2021) conducted a case report in Ischemic cardiomyopathy with ventricular tachycardia (n=1). Epicardial ablation vs. Endocardial ablation was evaluated on Ventricular tachycardia recurrence. Epicardial ablation successfully terminated recurrent ventricular tachycardia and prevented recurrence for at least two years in a patient with ischemic cardiomyopathy.
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