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Catheter Ablation of Mitral Isthmus Ventricular Tachycardia Using Electroanatomically Guided Linear Lesions
Author(s) -
FRIEDMAN PAUL A.,
PACKER DOUGLAS L.,
HAMMILL STEPHEN C.
Publication year - 2000
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2000.tb00343.x
Subject(s) - medicine , ablation , catheter ablation , cardiology , ventricular tachycardia , tachycardia , reentry , mitral valve , lesion , surgery
Electroanatomic Linear Ablation of Mitral Isthmus VT. Mitral isthmus ventricular tachycardia uses a reentrant circuit with a critical isthmus of conduction bounded by the mitral valve proximally and a remote inferior infarction scar distally. Successful catheter ablation requires placement of a lesion to transect the isthmus so as to prevent wavefront propagation. We report a case with previously unsuccessful ablation in which focal isthmus ablation failed to eliminate arrhythmia. Electroanatomic mapping demonstrated a wide tachycardia isthmus, and a linear lesion placed from the edge of the inferior infarct (as demonstrated on the three‐dimensional voltage electroanatomic map) to the base of the mitral valve successfully eliminated tachycardia. In some patients with mitral isthmus VT, a wide isthmus requires linear lesion placement to fully transect the isthmus and eliminate tachycardia. Electroanatomic mapping can be used to define isthmus boundaries and thus guide successful ablation.