Key result
CT-guided stereotactic radioablation treats incessant ventricular tachycardia from inaccessible transmural substrate.
Why the study?
Management of ventricular tachycardia in patients with inaccessible transmural substrate and apical thrombus poses clinical challenges requiring novel approaches.
Case Report (n=1)
Stereotactic ventricular tachycardia radioablation aided by CT-channels analysis may serve as a therapeutic option for patients with inaccessible transmural substrates.
May support CT-guided stereotactic radioablation in select refractory VT; hypothesis-generating, prospective validation required.
A 78-year-old man with a previous anterior myocardial infarction was referred to our Department after a cardiac arrest due to ventricular tachycardia (VT) episodes. He underwent implantable cardioverter defibrillator implantation, and, due to the presence of a thrombus in the apex, an epicardial-only ablation was planned. Electrophysiology study induced a monomorphic sustained VT (Cycle 530 ms, left bundle branch block (LBBB) morphology with superior axis) and activation mapping showed mid-diastolic signals in the inferoseptal apical region (Panel A), where radiofrequency was able to terminate the tachycardia, which was non-inducible afterwards (Supplementary material online). However, the patient suffered after 2 months from further incessant VT...
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Zucchelli et al. (2020) conducted a case report in Ventricular tachycardia (n=1). Stereotactic ventricular tachycardia radioablation aided by CT-channels analysis was evaluated. Stereotactic ventricular tachycardia radioablation aided by CT-channels analysis was utilized in a 78-year-old man with incessant ventricular tachycardia and an inaccessible transmural substrate.
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