RADIOFREQUENCY CATHETER ABLATION OF MULTIPLE MORPHOLOGIES OF VENTRICULAR-TACHYCARDIA BY TARGETING A SINGLE REGION OF THE LEFT-VENTRICLE

Introduction: As treatment options for ventricular tachycardia (VT) co ntinue to evolve, the use of radiofrequency catheter ablation is rapid ly expanding, However, in the presence of multiple morphologies of VT, achieving successful results may seem less likely, We report two pati ents with multiple morphologies of VT who underwent successful radiofr equency ablation by application of radiofrequency energy to a single r egion in the left ventricle. Methods and Results: Two patients, each w ithout any apparent cardiac dysfunction and a history of documented VT , were referred to our institution for further management, They underw ent an electrophysiologic study and were found to have easily inducibl e VT, of three morphologies in one patient and two in the other, Using a transaortic approach, left ventricular mapping was performed for de tecting a site with presystolic potentials, earliest ventricular activ ation, or both, Application of radiofrequency energy to a single area in the left ventricle resulted in the elimination of all previously in ducible VT in each patient. Conclusion: VTs with distinctly different morphologies can occur in patients with no detectable structural heart disease, These VT circuits may share a common pathway and, therefore, may readily be amenable to therapy with radiofrequency catheter ablat ion.