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KMID : 1011920100110040053
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International Journal of Arrhythmia
2010 Volume.11 No. 4 p.53 ~ p.58
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Ablation of ventricular tachycardia at coronary cusps in a patient who underwent surgical correction of tetralogy of Fallot
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Park Jong-Sung
Kim Sung-Soon
Pak Hui-Nam
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Abstract
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The appearance of ventricular tachycardia (VT) is a relatively common phenomenon in patients with tetralogy of Fallot (TOF) after a total correction operation. Although the main mechanism of monomorphic VT in TOF patients is known as a scar related reentry at the right ventricular outflow tract (RVOT), radiofrequency catheter ablation (RFCA) is challenging and there are substantial numbers of recurrences after successful ablation. A patient, who underwent TOF correction 25 years ago, was referred to our hospital for recurrent monomorphic VT. Although VT was entrainable at RVOT at the scar periphery, a 3D electroanatomical map showed centrifugal activation from the remote side, and radiofrequency (RF) energy delivery failed to terminate tachycardia. Therefore, we mapped the aortic cusp (AC) and finally eliminated VT at the left
coronary cusp successfully. Therefore, mapping of the left ventricular outflow tract might be valuable in some patients with VT who underwent TOF correction surgery.
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KEYWORD
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tetralogy of Fallot, ventricular tachycardia, aortic cusp
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