Epicardial Radiofrequency Catheter Ablation of Ventricular Tachycardia in the Vicinity of Coronary Arteries Is Facilitated by Fusion of 3-Dimensional Electroanatomical Mapping With Multislice Computed Tomography

Abstract

A 65-year-old male patient was referred for radiofrequency catheter ablation of a ventricular tachycardia (VT). The patient had a history of an anterior non–Q-wave infarction. Angiography revealed no significant lesions and normal left ventricular (LV) function. Before ablation, a contrast-enhanced 64-slice computed tomography (CT) scan was acquired. CT data were loaded into an electroanatomical (EA) mapping system (Biosense Webster, Inc, Diamond Bar, Calif) to provide 3-dimensional (3D) CT surface reconstruction of the coronary arteries and LV. Endocardial voltage mapping of the LV was performed during sinus rhythm and the 3D EA mapping data were merged with the 3D surface reconstruction data, allowing real-time visualization of the catheter tip in relation to the surface reconstruction (Figure 1). The clinical VT (cycle length 314 ms) was induced (Figure 2A). Endocardial …