Double ventricular tachycardias associated with an anatomical isthmus identified by a computed tomography-derived channel

J Cardiovasc Electrophysiol. 2020 Nov;31(11):3061-3063. doi: 10.1111/jce.14735. Epub 2020 Sep 14.


We describe a 47-year-old woman with ischemic ventricular tachycardia (VT) with repetitive implantable cardioverter-defibrillator shocks, requiring ablation. Preprocedural computed tomography (CT) demonstrated a single anatomical channel on the inferior-basal infarcted area between less than a 3-mm wall-thinning area and the mitral annulus, which suggested the circuit of two VTs observed. In addition, distribution of less than 2 mm and less than 3 mm wall-thinning area can explain the mechanism of the variation of the QRS morphology and S-QRS interval during entrainment. Ablation in this region resulted in no VT inducibility and the absence of any VTs for 2 years. CT wall thinning data may allow us to understand the mechanism and circuit of VT and aid VT ablation procedures.

Keywords: CT imaging; channel; ischemic cardiomyopathy; ventricular tachycardia; wall thinning.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Catheter Ablation*
  • Defibrillators, Implantable*
  • Female
  • Humans
  • Middle Aged
  • Tachycardia, Ventricular* / diagnostic imaging
  • Tachycardia, Ventricular* / etiology
  • Tachycardia, Ventricular* / surgery
  • Tomography
  • Tomography, X-Ray Computed