Case 66

Abstract

A 73-year-old man with a longstanding nonischemic cardiomyopathy and an implantable defibrillator placed for secondary prevention of sudden death was referred for increasingly frequent ICD shocks due to rapid VT. Interrogation of his ICD revealed three distinct intracardiac morphologies. He was referred for EP study and voltage mapping, at which time he had a single VT morphology reproducibly induced with programmed stimulation (Fig. 66.1). The intracardiac electrograms of this induced tachycardia matched one of the patient's dominant clinical arrhythmias. Biventricular voltage maps were normal with the exception of a small area of attenuated electrograms at the lateral mitral annulus (Fig. 66.2). © Springer-Verlag London Limited 2011.