Highlights the importance of considering macroreentrant VT and arrhythmogenic right ventricular cardiomyopathy (ARVC) in the differential diagnosis of RVOT VT for effective management.
Re-evaluation after failed RVOT VT ablation may identify ARVC-related macroreentry; case reports leave open broader applicability.
We present a case involving an initially unsuccessful ablation attempt of a right ventricular outflow tract (RVOT) ventricular tachycardia (VT) and the subsequent management that provided a definitive diagnosis and effective treatment. VT with left bundle branch block morphology and an inferior axis is often caused by focal tachycardia arising from the RVOT. The differential for this arrhythmia includes a macroreentrant VT. This can be due to arrhythmogenic right ventricular cardiomyopathy (ARVC),1 which is diagnosed using a combination of clinical cues and electrical and noninvasive imaging to meet the Task Force Criteria.
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Graham et al. (2018) studied this question.
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