Key result
Catheter ablation of the epicardial surface eliminated the VT, and endocardial unipolar voltage mapping successfully predicted the site of the epicardial arrhythmogenic substrate.
Why the study?
Does endocardial unipolar voltage mapping predict epicardial arrhythmogenic substrates better than bipolar mapping in a patient with left ventricular aneurysm and ventricular tachycardia?
Case Report (n=1)
Does endocardial unipolar voltage mapping predict epicardial arrhythmogenic substrates better than bipolar mapping in a patient with left ventricular aneurysm and ventricular tachycardia?
Endocardial unipolar voltage mapping may be helpful for predicting epicardial arrhythmogenic substrates in patients with left ventricular aneurysms undergoing VT ablation.
Endocardial unipolar mapping may predict epicardial VT substrate in LV aneurysm; hypothesis-generating and requires prospective validation.
A 62-year-old man with severe coronary artery disease and a left ventricular aneurysm underwent catheter ablation of ventricular tachycardia (VT) with right bundle branch block QRS morphology. Endocardial bipolar voltage mapping with standard threshold settings demonstrated no low-voltage areas within the aneurysm. Catheter ablation of the epicardial surface of the aneurysm eliminated the VT. Endocardial bipolar voltage mapping with any other settings could not predict the site of the epicardial arrhythmogenic substrate whereas endocardial unipolar voltage mapping could. Endocardial unipolar voltage mapping may be helpful for predicting epicardial arrhythmogenic substrates.
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Yamada et al. (2010) conducted a case report in Epicardial Macroreentrant Ventricular Tachycardia Associated with a Left Ventricular Aneurysm (n=1). Catheter ablation and endocardial unipolar voltage mapping was evaluated on Elimination of ventricular tachycardia and prediction of epicardial arrhythmogenic substrate. Catheter ablation of the epicardial surface eliminated the VT, and endocardial unipolar voltage mapping successfully predicted the site of the epicardial arrhythmogenic substrate.
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