The Use of Nonfluoroscopic Catheter-Based Mapping System to Perform Radiofrequency Ablation in Complex Ventricular Tachycardia after Cardiac Surgery in Congenital Heart Disease : A Case Report
CHARN SRIRATANASATHAVORN, M.D.*, ONGKARN RAUNGRATANAAMPORN, M.D.*, KOONLA WEE NADEMANEE, M.D.***, SUPHACHAI CHAITHIRAPHAN, M.D.* KERTUAI BHURIPANYO, M.D.*, RUNGROJ KRITTAYAPHONG, M.D.**, BURIN KWO-SA-ARD,B.Sc.*,
Affiliation : * Her Majesty Cardiac Center, ** Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University. Bangkok 10700, Thailand. *** Division of Cardiology, Department of Medir:ine, University of Southern California School of Medicine, LA, USA.
A nonfluoroscopic electroanatomical cardiac mapping system (CARTO) integrates ana- tomical and electrophysiological information to reconstruct a three-dimensional activation map. Information from the CARTO system helps to reveal the mechanism and perform successful abla- tion in scar re-entry ventricular tachycardia after cardiac surgery. Three-dimensional activation and propagation mapping was performed in .: patient with ventricular tachycardia after surgical correc- tion of a double outlet right ventricle. The ventricular tachycardia appeared in two morphologies and were refractory to antiarrhythmic medication including amiodarone. Both ventricular tachycardias were re-entered using the ventriculotomy scar but rotated in different directions. Successful radio- frequency ablation was performed by creating a line of conduction block from the pulmonic valve to the ventriculotomy scar using entrainment mapping and the ablation lesion tagging technique. The CARTO system is useful in mapping and guiding the ablation of complex ventricular tachy- cardia after surgical correction in congenital heart disease
Keywords : Nonfluoroscopic Electroanatomical Cardiac Mapping System, Ventricular Tachy- cardia, Radiofrequency Ablation, Congenital Heart Disease
