Idiopathic Ventricular Tachycardia Cured by Radiofrequency Application from the Distal Great Cardiac Vein and the Left Coronary Cusp

Takehiro Kimura, Seiji Takatsuki, Kotaro Fukumoto, Nobuhiro Nishiyama, Yoshiyasu Aizawa, Shunichiro Miyoshi, Keiichi Fukuda

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

A 79 year-old male without structural heart disease suffered from drug refractory ventricular tachycardia (VT). VTs and premature ventricular complexes (PVCs) with the same morphology occurred incessantly with a concordant R pattern in chest leads and a tall R in Lead II, III, and aVF. The origin was expected to be near the left epicardial ventricular outflow tract (LVOT), which was termed the left ventricular summit area. Pace-mapping from the LVOT and the left coronary cusp (LCC) did not match well with the QRS morphology of the PVC. A good match was obtained from the distal great cardiac vein (GCV), and radiofrequency (RF) delivery eliminated the PVC and VT. However, the PVC recurred four times upon cessation of RF delivery. By placing an ablation catheter at the LCC, we obtained pace-mapping showing two different types of QRS morphologies; one was an rS pattern in V1, and the other was an R pattern in V1 with a longer stimulus to QRS interval, which was a nearly perfect match to the PVC. RF application to the LCC permanently eliminated PVCs and VTs. Several VTs from the epicardial LVOT can be cured by RF application from both the distal GCV and the LCC.

Original languageEnglish
Pages (from-to)193-196
Number of pages4
JournalHeart Lung and Circulation
Volume23
Issue number2
DOIs
Publication statusPublished - 2014 Feb 1

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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