Successful Epicardial Radiofrequency Ablation of Ventricular Tachycardia That Shared a Pathway with Bi-Directional Conduction in a Patient with Human Immunodeficiency Virus-Associated Cardiomyopathy

Daisuke Togashi; Tomoo Harada; Ikutaro Nakajima; Akira Kasagawa; Yui Nakayama; Kenichi Sasaki; Yoshihiro J. Akashi

doi:10.1536/ihj.23-205

Case Reports

Successful Epicardial Radiofrequency Ablation of Ventricular Tachycardia That Shared a Pathway with Bi-Directional Conduction in a Patient with Human Immunodeficiency Virus-Associated Cardiomyopathy

Daisuke Togashi, Tomoo Harada, Ikutaro Nakajima, Akira Kasagawa, Yui Nakayama, Kenichi Sasaki, Yoshihiro J. Akashi

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Keywords: Isochronal late activation map, Deceleration zone, Epicardial ablation

JOURNAL FREE ACCESS

2023 Volume 64 Issue 6 Pages 1157-1161

DOI https://doi.org/10.1536/ihj.23-205

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Abstract

A 59-year-old man who had been diagnosed with human immunodeficiency virus-associated cardiomyopathy was referred for catheter ablation of ventricular tachycardia (VT). An electrocardiogram (ECG) waveform revealed that the clinical VT originated from the epicardium. A deceleration zone (DZ) was identified on an isochronal late activation map. Moreover, 2 forms of monomorphic VT were induced by different cycle length burst pacings from near the DZ. The morphologies of the 2 VTs with an identical cycle length were very likely to use a shared common pathway with bi-directional conduction around the slow conduction area in the left ventricle posterolateral small epicardial surface area. After ablation of the DZ, the VT was uninducible.

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