Catheter ablation of mitral isthmus ventricular tachycardia using electroanatomically guided linear lesions

Paul A. Friedman, Douglas L. Packer, Stephen C. Hammill

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Electroanatomic Linear Ablution 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 tires guide successful ablation.

Original languageEnglish (US)
Pages (from-to)466-471
Number of pages6
JournalJournal of cardiovascular electrophysiology
Volume11
Issue number4
DOIs
StatePublished - Jan 1 2000

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Keywords

  • Arrhythmia mapping
  • Catheter ablation
  • Electroanatomic mapping
  • Mitral isthmus
  • Reentry
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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