Right Ventricular Outflow Tract Tachycardia with Structural Abnormalities of the Right Ventricle and Left Ventricular Diverticulum

Bortolo Martini,Nicola Trevisi,Nicolò Martini,Li Zhang

doi:10.1155/2015/708687

Abstract

A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT). ECG showed a QRS in left bundle branch block morphology with inferior axis. Echocardiography, ventricular angiography, and cardiac magnetic resonance imaging (CMRI) revealed a normal right ventricle and a left ventricular diverticulum. Electrophysiology studies with epicardial voltage mapping identified a large fibrotic area in the inferolateral layer of the right ventricular wall and a small area of fibrotic tissue at the anterior right ventricular outflow tract. VT ablation was successfully performed with combined epicardial and endocardial approaches.

Highlights

Right ventricular outflow tract tachycardia (RVOT-ventricular tachycardia (VT)), while being often classified as an idiopathic ventricular arrhythmia, has been found to have structural cardiac abnormalities in some cases [1]
A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT)
Right ventricular outflow tract tachycardia (RVOT-VT), while being often classified as an idiopathic ventricular arrhythmia, has been found to have structural cardiac abnormalities in some cases [1]. Such cases probably represent an atypical manifestation of arrhythmogenic right ventricular dysplasia cardiomyopathy (ARVD/C)

Summary

Introduction

Right ventricular outflow tract tachycardia (RVOT-VT), while being often classified as an idiopathic ventricular arrhythmia, has been found to have structural cardiac abnormalities in some cases [1]. Such cases probably represent an atypical manifestation of arrhythmogenic right ventricular dysplasia cardiomyopathy (ARVD/C). Left ventricular diverticulum (LVD), a rare cardiac malformation, can be a standalone condition or associated with other cardiac abnormalities. We report a case with a rare combination of atypical ARVC/D with an LVD and with RVOT-VT as a primary presentation

Case Report

Discussion

Conclusions