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Case Reports
. 2024 Jun 3;10(8):595-599.
doi: 10.1016/j.hrcr.2024.05.021. eCollection 2024 Aug.

Help from the little guy: Intramural ischemic ventricular tachycardia ablation leveraging a 2F multipolar catheter in a coronary vein

Jacob N Blackwell  1 , N A Mark Estes 3rd  1 , Alaa A Shalaby  1
Affiliations
Case Reports

Help from the little guy: Intramural ischemic ventricular tachycardia ablation leveraging a 2F multipolar catheter in a coronary vein

Jacob N Blackwell et al. HeartRhythm Case Rep. .
No abstract available

Keywords: Intramural arrhythmia substrate; Multipolar ablation; Radiofrequency ablation; Ventricular tachycardia; Ventricular tachycardia mapping.

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Conflict of interest statement

The authors of this manuscript have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Clinical ventricular tachycardia (VT) and substrate. A: Twelve-lead electrocardiogram of apical anteroseptal VT. B: Combined left ventricular (LV) and right ventricular activation map encompassing 77% of the total cycle length, with earliest LV activation denoted by green dot. C: LV voltage map (1.5 mV–0.05 mV) and isochronal late activation map with earliest LV activation site denoted by green dot.
Figure 2
Figure 2
A: Anatomic shell depicting the areas of earliest activation for left ventricle and right ventricle (green dot) and anterior interventricular vein (AIV) (green asterisk). B: Pacing from earliest AIV activation site (green asterisk) via the distal multipolar catheter resulted in 98% morphologic match to clinical ventricular tachycardia (VT). C: Entrainment from AIV earliest activation site resulted in concealed fusion and was suggestive of VT exit site.
Figure 3
Figure 3
A: Radiographic and mapping system depiction of ablation vector between left ventricle (LV) endocardial ablation catheter and anterior interventricular vein–positioned multipolar catheter. B: Final lesion set created by adjusting the LV endocardial ablation catheter position in relation to the multipolar catheter. C: Generator setup for multipolar ablation with EPstar 6 (Baylis Medical) connected to the ampere return via the red jumper cable (red arrow) and EPstar 8 (Baylis Medical) connected to the ampere return via the black jumper cable (yellow arrow).
See this image and copyright information in PMC

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