Paolo Della Bella, Augusto Pappalardo*, Claudio Tondo, Corrado Carbucicchio, Stefania Riva.
Centro Cardiologico “Monzino”, Istituto di Cardiologia, Universita degli Studi di Milano, * Dipartimento di Cardioscienze, Azienda Ospedaliera S. Camillo-Forlanini, Rome, Italy
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Conventional mapping of hemodynamically untolerated ventricular
tachycardia is prevented by the necessity of a rapid termination of the arrhythmia. Recent studies have
demonstrated that a novel non contact mapping system (Esi 3000, Endocardial solutions) can perform an accurate
reconstruction of the entire endocardial activation of a single beat of ventricular tachycardia and guide
subsequent ablation, during sinus rhythm.
We report 3 cases of non contact mapping of untolerated ventricular tachycardia. They all had a drug resistant
inducible hemodynamically unstable ventricular tachycardia three monomorphic untolerated ventricular
tachycardias (1 per patient) were induced, mapped for few seconds and then terminated. Subsequent off-line
analysis of the VT allowed the detection of the exit point and part of the diastolic pathway of the 3 VTS.
Successful radiofrequency catheter ablation, guided by non contact mapping during sinus rhythm, was
performed in all cases.
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