CATHETER ABLATION OF VENTRICULAR-TACHYCARDIA IN CHAGASIC CARDIOMYOPATHY

There is a limited experience with catheter ablation for treatment of ventricular tachycardia (VT) in Chagasic cardiomyopathy. A 30-year-old woman experienced episodes of palpitations and syncope due to attacks of VT. A diagnosis of Chagas disease was established on a biological basis. Two-dimensional echo and contrast ventriculography showed an ap ical aneurysm with thrombus. Surgery was indicated to resect the aneur ysm and ablate the VT. Ventricular tachycardia recurred 1 month later despite therapy, including amiodarone. Two clinical frequent and well- tolerated tachycardias were identified. The site of origin was located in the right ventricular apex and in the apical-lateral wall of the l eft ventricle, respectively. Catheter ablation was performed at two si tes with DC shocks (total energy 600 J) after unsuccessful radiofreque ncy ablation. Holter recordings performed during the postoperative per iod showed only infrequent extrasystoles. After follow-up of 24 months the patient remains asymptomatic. Drug-refractory VT in Chagasic card iomyopathy can be ablated by medium-energy DC shocks after failure of radiofrequency ablation.