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This case highlights that fibrotic reaction around a pacing/defibrillation lead in diseased myocardium can contribute to the creation of a reentry circuit causing ventricular tachycardia, which can be successfully treated with radiofrequency ablation.
The case of a 57-year-old woman with a longstanding history of obstructive hypertrophic cardiomyopathy in dilatative phase and incessant monomorphic ventricular tachycardia is reported. Endocardial recordings and electroanatomic mapping suggested local reentry involving right ventricular apical septum, close to a pacing/defibrillation lead tip. Radiofrequency pulses delivered at this site resulted in definite cure of the arrhythmia. It is possible that fibrotic reaction around pacing/defibrillation lead in a diseased myocardium substrate has contributed to the creation of a reentry circuit.
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Casella et al. (2007) studied this question.
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