Ablation of Refractory Papillary Muscle Ventricular Tachycardia Warranting Multiple Adjunctive Ablation Techniques: A Combined Approach for Success

Authors

Mark Pollet
Ben Jenny
Adwait Mehta
Austin Howard
Nilesh Mathuria

Publication Date

2-1-2020

Journal

The Journal of Innovations in Cardiac Rhythm Management

Abstract

A 27-year-old male presented to our institution with recurrent unifocal premature ventricular contraction/nonsustained ventricular tachycardia (VT) with associated cardiomyopathy. The patient had undergone three prior ablation procedures with continued arrhythmia. Mapping led to identification of the VT arising from the basal aspect of the left ventricular anterolateral papillary muscle. Conventional ablation techniques were unsuccessful. We incorporated adjunctive ablation techniques in this case that ultimately led to a successful outcome. The present discussion covers the roles of intracardiac echocardiography, induced apnea, and low-ionic irrigation.

Keywords

Ablation, papillary muscle, ventricular tachycardia