Authors: Yuichi Hori Shiro Nakahara Sohtaro Mine Naofumi Anjo Akiko Fujii Yoshihiko Ueda Isao Taguchi
Publish Date: 2016/05/13
Volume: 31, Issue: 12, Pages: 2068-2073
Abstract
A 65yearold man with nonischemic cardiomyopathy underwent an autopsy 2 months after the successful ablation of a sustained left ventricular LV summit ventricular tachycardia VT The patient died due to interstitial pneumonia from amiodarone use The earliest activation sites of the VT were documented from both inside the anterior interventricular vein AIV and epicardial surface The diameter of the AIV was 3–4 mm and the radiofrequency RF lesion inside the AIV was a slight lesion due to high impedance with a high temperature The lesion from the epicardial surface was also superficial and insufficient due to neighboring coronary arteries and the existence of epicardial fat A successful application was performed from the LV endocardium and diffuse myocardial fibrosis was observed in the midmyocardium including inside the RF lesions The actual relationship between the myocardial fibrosis and LV summit VT remains unclear but this case showed the difficulty of achieving a successful ablation from the epicardial side when the focus exists in the midmyocardium around the LV summit
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