Back to Search
Start Over
Right ventricular free-wall scar: an exceptional source of post-infarction ventricular tachycardia. A case report.
- Source :
-
European heart journal. Case reports [Eur Heart J Case Rep] 2019 Jun 01; Vol. 3 (2). - Publication Year :
- 2019
-
Abstract
- Background: In patients with coronary artery disease, ventricular tachycardia (VT) is usually related to left ventricular (LV) post-infarction scars.<br />Case Summary: A case of a 78-year-old man with post-infarction VT originating from the right ventricular (RV) free wall is described. Following recurrent episodes of VT with left bundle branch block morphology and left superior axis deviation, a patient with prior myocardial infarction was submitted to catheter ablation. Two areas of abnormal bipolar electrograms were observed at 3D electroanatomical mapping: one located at the basal aspect of the posterior and postero-septal LV, and the other one extending from the antero-lateral to the posterior mid-basal RV free wall. Ventricular late potentials (LPs) were recorded within both scars, but only pacing from those located in the RV resulted in long stimulus-to-QRS latency and optimal pace-mapping. Accordingly, this substrate was deemed the culprit of the clinical VT. Radiofrequency catheter ablation aimed at eliminating all LPs recorded from both scars was effective in preventing VT recurrences at follow-up.<br />Discussion: A post-infarction RV free-wall scar may exceptionally be responsible of VT occurrence. Right ventricular mapping should be considered in selected cases based on 12-lead electrocardiogram VT morphology and prior RV infarct.<br /> (© The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Details
- Language :
- English
- ISSN :
- 2514-2119
- Volume :
- 3
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- European heart journal. Case reports
- Publication Type :
- Academic Journal
- Accession number :
- 31449624
- Full Text :
- https://doi.org/10.1093/ehjcr/ytz067