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Case Report of a Recurrent Monomorphic Ventricular Tachycardia in a Patient with Myocarditis - Importance of Targeting Midmyocardial Anatomic Substrate
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  • Usha Tedrow,
  • Uyanga Batnyam,
  • Carolina Hoyos-Ochoa,
  • Jorge Romero
Usha Tedrow
Brigham and Women's Hospital Division of Cardiovascular Medicine
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Uyanga Batnyam
Brigham and Women's Hospital Division of Cardiovascular Medicine
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Carolina Hoyos-Ochoa
Brigham and Women's Hospital Division of Cardiovascular Medicine
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Jorge Romero
Brigham and Women's Hospital Division of Cardiovascular Medicine

Corresponding Author:[email protected]

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Abstract

A 56-year-old man with non-ischemic cardiomyopathy with three prior ablations targeting two different MMVTs presented with recurrent VT. Therefore, he underwent epicardial mapping with adjuvant CT imaging which demonstrated midmyocardial scar. Fractionated potentials noted during mapping in this region, and entrainment suggested inner loop. Interestingly, pacing showed two different QRS morphologies identical to his previously ablated VTs with a long stim-QRS at this region. Epicardial ablation carried on during the VT successfully terminated it, but the VT remained inducible and required endocardial ablation to make it noninducible. The patient has been VT-free for 12 months following this ablation off antiarrhythmic drugs.
22 Apr 2024Submission Checks Completed
22 Apr 2024Assigned to Editor
23 Apr 2024Reviewer(s) Assigned
11 Jun 20241st Revision Received
30 Jun 2024Review(s) Completed, Editorial Evaluation Pending