Successful Noninvasive 12-Lead ECG Mapping-Guided Radiotherapy of Inaccessible Ventricular Tachycardia Substrate Due to Mechanical Valves

Lucas K Keyt; Todd Atwood; Andrew Bruggeman; Arno J Mundt; Gregory K Feld; David E Krummen; Gordon Ho

doi:10.1016/j.jaccas.2023.101870

Successful Noninvasive 12-Lead ECG Mapping-Guided Radiotherapy of Inaccessible Ventricular Tachycardia Substrate Due to Mechanical Valves

JACC Case Rep. 2023 May 6:15:101870. doi: 10.1016/j.jaccas.2023.101870. eCollection 2023 Jun 7.

Authors

Lucas K Keyt¹, Todd Atwood², Andrew Bruggeman², Arno J Mundt², Gregory K Feld¹, David E Krummen¹, Gordon Ho¹

Affiliations

¹ Department of Medicine, Division of Cardiology, University of California-San Diego, La Jolla, California, USA.
² Department of Radiation Medicine and Applied Sciences, University of California-San Diego, La Jolla, California, USA.

Abstract

In patients presenting with refractory ventricular tachycardia (VT) and aortic and mitral mechanical prosthetic valves, traditional catheter ablation is challenging. We describe a case in which a novel noninvasive computational electrocardiogram mapping algorithm localized VT sources originating from substrate near the mechanical valves, in which stereotactic ablative radiotherapy eliminated VT in 1.5-year follow-up. (Level of Difficulty: Advanced.).

Keywords: emerging technologies and innovations; ventricular arrythmia.

Publication types

Case Reports