Key result
Endocardial catheter ablation with substrate modification successfully resolved recurrent ventricular tachycardia precipitated by an epicardial left ventricular lead in a patient with ischemic cardiomyopathy.
Case Report (n=1)
No
Endocardial catheter ablation can successfully treat electrical storm precipitated by an epicardial left ventricular lead in patients undergoing CRT upgrade, allowing for the continuation of biventricular pacing.
May enable CRT continuation in select lead-related VT cases; leaves open need for prospective validation.
A patient with ischemic cardiomyopathy and an implantable cardioverter-defibrillator underwent an upgrade with an epicardial left ventricular lead, which precipitated recurrent ventricular tachycardia (VT). An electrophysiological study with electroanatomic mapping showed the site of the left ventricular lead to be part of the re-entrant circuit, and substrate modification of an endocardial channel led to the resolution of VT and an improvement in symptoms.
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Rauf et al. (2023) conducted a case report in Ischemic cardiomyopathy with recurrent ventricular tachycardia precipitated by CRT (n=1). Endocardial catheter ablation (substrate modification) was evaluated on Resolution of ventricular tachycardia. Endocardial catheter ablation with substrate modification successfully resolved recurrent ventricular tachycardia precipitated by an epicardial left ventricular lead in a patient with ischemic cardiomyopathy.
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