Abstract
Ventricular tachycardia (VT) and ventricular fibrillation (VF) are the most common causes of sudden cardiac death. Currently, knowledge of the reentrant mechanism of monomorphic VT circuits in relation to complex scar anatomy allows for various mapping techniques including electroanatomic and entrainment mapping to accomplish catheter ablation of VT.1, 2 Clinically, it may be observed that ablation to eliminate recurrent macro-reentrant VT may also eliminate recurrent VF, as defined for instance by electrograms from implanted cardioverter-defibrillators (ICD).3, 4 However, whether this represents elimination of the VT trigger for VF, or directly of the substrate for VF, is unclear since the mechanism of VF in relation to scar is not known. Recent work targeting localized rotors in atrial fibrillation ablation has shown promise,5 but its implications for VF are unknown. We report here a case where VT termination and a VF rotor occurred at spatially coincidental sites in a patient with ischemic cardiomyopathy, suggesting that VF rotors may localize to the same anatomic substrate that promotes VT.
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