Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
CASE REPORTS
Histopathological Verification for Successful Ablation of Mitral Isthmus Ventricular Tachycardia Complicated with Cardiac Sarcoidosis
Yoshiaki KanekoOsamu IgawaTadanobu IrieMasamitsu AdachiTadashi NakajimaHideaki YokooYoichi NakazatoMasahiko Kurabayashi
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JOURNALS OPEN ACCESS

Volume 51 (2012) Issue 3 Pages 281-285

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Abstract

A 68-year-old man died a few days after catheter ablation of drug-resistant, monomorphic ventricular tachycardia (VT) complicated with cardiac sarcoidosis. The diagnosis of mitral isthmus VT was made from electrophysiological observations, including electro-anatomical activation and voltage map, pace-mapping, entrainment mapping and ablation outcome. On autopsy of the heart, sarcoidic lesion with scattered fibrous tissue in the mitral isthmus was non-transmural, and the surviving myocardium serving as the reentry circuit in the endomyocardium was isolated from the adjacent viable epimyocardium, enabling the sustenance of macroreentry across the mitral isthmus. Non-transmural lesions produced by RF delivery created a barrier sufficient to interrupt the myocardial bundles located in the mitral isthmus, eliminating the mitral isthmus VT.

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© 2012 by The Japanese Society of Internal Medicine
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