Epicardial Macroreentrant Ventricular Tachycardia Associated with a Left Ventricular Aneurysm


  • Funding sources: None.

  • Disclosures: Drs. Kay and McElderry have participated in catheter research funded by Biosense Webster and Irvine Biomedical. Dr. McElderry has received consulting fees from Boston Scientific, St. Jude Medical, and Biosense Webster.

Address for reprints: Takumi Yamada, M.D., Ph.D., Division of Cardiovascular Disease, University of Alabama at Birmingham, VH B147, 1670 University Boulevard, 1530 3rd AVE S, Birmingham, AL 35294-0019 USA. Fax: +1-205-975-4720; e-mail: takumi-y@fb4.so-net.ne.jp


A 62-year-old man with severe coronary artery disease and a left ventricular aneurysm underwent catheter ablation of ventricular tachycardia (VT) with right bundle branch block QRS morphology. Endocardial bipolar voltage mapping with standard threshold settings demonstrated no low-voltage areas within the aneurysm. Catheter ablation of the epicardial surface of the aneurysm eliminated the VT. Endocardial bipolar voltage mapping with any other settings could not predict the site of the epicardial arrhythmogenic substrate whereas endocardial unipolar voltage mapping could. Endocardial unipolar voltage mapping may be helpful for predicting epicardial arrhythmogenic substrates. (PACE 2012; 35:e13–e16)