Key result
Multimodality imaging with 3D TEE identifies post-VT ablation anatomy, confirming a true LV aneurysm.
Why the study?
While LV pseudoaneurysm is a recognized complication of VT ablation, true LV aneurysm has been reported only rarely, and differentiating between the two can be challenging.
Case Report (n=1)
Multimodality imaging can improve anatomical characterization and guide surgical management in patients presenting with the rare complication of a true left ventricular aneurysm after catheter ablation for ventricular tachycardia.
Answers are grounded in this paper and cite their sources.
Echocardiography alone may misclassify post-VT ablation LV aneurysms; leaves open the role of ventriculography and 3D TEE for accurate diagnosis.
BACKGROUND: Left ventricular (LV) pseudoaneurysm is an uncommon but recognized complication of ventricular tachycardia (VT) ablation. In contrast, true LV aneurysm has been reported only rarely. CASE SUMMARY: Transthoracic echocardiogram, supported by cardiovascular magnetic resonance imaging, initially suggested an LV pseudoaneurysm in a patient after VT ablation. During evaluation for percutaneous closure, left ventriculogram and 3-dimensional transesophageal echocardiogram revealed more complex anatomy, prompting referral for surgical repair. Intraoperative findings confirmed a true LV aneurysm. DISCUSSION: True LV aneurysm may represent a rare complication of deep radiofrequency energy delivery during catheter ablation resulting in myocardial injury. Because differentiating true aneurysms from pseudoaneurysms can be challenging, a multimodality imaging approach may improve anatomical characterization, guide management, and enhance understanding of the underlying mechanism. TAKE-HOME MESSAGE: Multimodality imaging can improve anatomical characterization and procedural planning in patients with the rare complication of true left aneurysm after catheter ablation.
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Nanthakumar et al. (2026) conducted a case report in True left ventricular aneurysm after ventricular tachycardia ablation (n=1). Multimodality imaging and surgical repair was evaluated. Multimodality imaging including 3D transesophageal echocardiography identified complex anatomy after VT ablation in 1 patient, leading to surgical confirmation of a true LV aneurysm.
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