Case 62

Abstract

The patient is a 57-year-old woman with newly diagnosed nonischemic dilated cardiomyopathy (LVEF 25-30%) and >11,000 uniform VPCs during a 24-h Holter monitor. She presented for electrophysiology study for ablation of the VPC focus (Fig. 62.1) and to assess for inducible sustained ventricular tachycardia. 3-D electroanatomic activation mapping was performed with a 4-mm Navistar RMT catheter utilizing the CARTO and Stereotaxis remote magnetic navigation systems. Earliest activation (0 ms presystolic) of the recurring VPCs within the right heart was localized to the anteroseptal RVOT, just below the pulmonary valve. Pacemapping was also performed and an 11/12-lead morphology match was achieved at the same site as the earliest activation. © Springer-Verlag London Limited 2011.