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Surgical Catheter Ablation of Ventricular Tachycardia Using Left Thoracotomy in a Patient with Hindered Access to the Left Ventricle
Author(s) -
MAURY PHILIPPE,
MARCHEIX BERTRAND,
DUPARC ALEXANDRE,
HÉBRARD AURÉLIEN,
PAQUIE CAROLINE,
MONDOLY PIERRE,
ROLLIN ANNE,
DELAY MARC
Publication year - 2009
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2009.02322.x
Subject(s) - medicine , ventricle , cardiology , ablation , coronary sinus , percutaneous , catheter ablation , thoracotomy , ventricular tachycardia , aortic sinus , catheter , tachycardia , surgery , aorta
We report the case of a patient presenting with incessant monomorphic ventricular tachycardia resistant to antiarrhythmic drugs, and in whom usual percutaneous vascular or pericardial access to the left ventricle was hindered by mechanical aortic and mitral prosthetic valves. Because an epicardial location was suspected by electrocardiogram features and because access to the target area through the coronary sinus was not possible, we decided to perform a surgically based radiofrequency (RF) ablation. Catheter mapping of the epicardial surface through surgical left lateral thoracotomy in the operating room confirmed the epicardial location of the arrhythmogenic substrate and allowed successful RF ablation of the clinically incessant tachycardia. Combined surgical and electrophysiological approach should therefore be performed when RF ablation is needed in case of unadvisable, difficult, or failed nonsurgical percutaneous access.