Ventricular tachycardia is a potentially life threatening condition where the heart rate goes very high and can cause sudden death unless treated in emergency. Various treatment modalities are available for VT, including Drugs, special pacemakers called ICD (Implantable Cardioverter Defibrillator). The newest modality of therapy is Radiofrequency Catheter Ablation of VT.
Here we describe the case of a 55 years old male who had heart attack 5 years back. Stenting of coronary artery was done as part of management of heart attack. But the heart attach resulted in reduced pumping capacity of the heart. A special pacemaker called CRT-D (Cardiac Resynchronization therapy with Defibrillator) was put in 2019. This time the patient presented with multiple electrical shocks from the Defibrillator. We took up case for VT ablation. Catheter Ablation of VT was done by Dr Anupam Jena (Interventional Cardiologist & Electrophysiologist) with 3D mapping. Both Endocardial and Epicardial mapping was done. Catheter ablation was done with real time monitoring by use of Intracardiac Echocardiography (ICE). The patient remained well and was discharged after 3 days.
Figure 1. Shows Epicardial Mapping of VT
Figure 2. Endocardial and Epicardial Mapping of VT
Figure 3. Endo-Epicardial Propagation map
Figure 4. Realtime monitoring of Ablation with use of Intracardiac Echocardiography. The microbubbles formed at the catheter tip suggest effective ablation
The procedure went successfully and at the end of the procedure tachycardia was noninducible
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