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Identification of an epicardial slow conduction channel using ripple mapping in ablation of postinfarct ventricular tachycardia.

Tomomasa TakamiyaOsamu InabaJunichi NittaMasahiko Goya
Published in: Journal of cardiovascular electrophysiology (2019)
An 82-year-old man underwent redo catheter ablation of ventricular tachycardia (VT) after anterior infarction. A ripple mapping conducting channel (RMCC) was identified within the anterior scar in the left ventricular epicardium during sinus rhythm. Along the RMCC, delayed potentials during sinus rhythm, a good pace map with a long stimulus to the QRS interval, and mid-diastolic potentials during VT were recorded, and epicardial ablation at this site eliminated the VT. These findings suggested that the RMCC in the epicardial scar served as a critical isthmus of the postinfarct VT, and ablation targeting the RMCC was effective.
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