%0 Journal Article
%T Aortic Sinus of Valsalva Aneurysm Isolation by Radiofrequency Ablation in Outflow Tract Ventricular Tachycardia
%A Nicholas Olson
%A Scott W. Ferreira
%A Peter C. Mikolajczak
%A Ali Mehdirad
%J World Journal of Cardiovascular Diseases
%P 131-137
%@ 2164-5337
%D 2014
%I Scientific Research Publishing
%R 10.4236/wjcd.2014.44019
%X Idiopathic monomorphic ventricular tachycardia and premature ventricular complexes (PVCs) commonly arise from the right and left ventricular outflow tracts (VOT). Their mechanism is most commonly triggered activity from delayed after-depolarizations and successful ablation is performed at the site of earliest endocardial activation. Re-entrant mechanisms have been rarely described. We report a case of an otherwise healthy patient who ultimately underwent six electro-physiology studies (EPS) and suffered numerous implantable cardiac defibrillator (ICD) discharges prior to the successful radiofrequency ablation (RFA) of two idiopathic VOT tachycardias. During the sixth EPS, a proximal aortogram demonstrated a left aortic sinus of valsalva (LASV) aneurysm. Subsequntly, a novel and successful RFA strategy of aneurysm isolation was undertaken. The presence of multiple clinical or inducible VT morphologies and the characterization of a VT as re-entrant should raise concerns that a complex arrhythmogenic substrate is present and defining the anatomy with angiography or an alternative imaging modality is essential in achieving a successful ablation strategy.
%K Ventricular Tachycardia
%K Outflow Tract
%K Aortic Cusp
%K Sinus of Valsalva
%K Aneurysm
%K Normal Heart
%K Radiofrequency Ablation
%K Re-Entry
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=44443