ENDOCARDIAL ELECTROANATOMICAL SUBSTRATE AND CATHETER ABLATION IN PATIENTS WITH NONISCHEMIC CARDIOMYOPATHY AND MONOMORPHIC VENTRICULARTACHYCARDIA

摘要

The purpose of this study was to examine the relationship between the reentrant circuits of ventricular tachycardia (VT) and an abnormal myocardium in arrhythmogenic right ventricular cardiomyopathy (ARVC) and cardiac sarcoidosis (SARC) by using the electro-anatomical mapping system (CARTO), and to assess the feasibility of the establishment of a block line in the reentrant circuit isthmus guided by CARTO. Methods & Results An EP study and catheter ablation(CA) were performed in 17 ARVD pattents(13 men, 47+-17yr) and 5 SARC patients(3 men, 55+-13yr) using CARTO. Endocardial mapping during sinus rhythm(SR) was performed in all patients to evaluate the relationship between the site of abnormal electrograms and the reentrant circuits. A total of 26 VTs (13 stable, 13 unstable) were induced in the ARVD group and 5 VTs(4 stable 1 unstable) in the SARC group. ARVD: The reentrant circuit and critical site for the CA were identified in 10 of 13 stable VTs(6 reentrant and 4 focal) in the ARVD group. The Activation pattern during the reentrant VT exhibited figure-of-8 reentry in 4 VTs and single-loop-reentry in 2. All VTs were terminated by several RF applications (average 11+-6; 40W*60sec) at the critical isthmus of the circuit. Those isthmi were located predominantly around the tricuspid annulus (TA) in the ARVD group.