vt, presyncope, and epicardial scar in cmr is it idiopathic?or+scar+related+v… · •vt was...
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VT, Presyncope, and Epicardial Scar in CMR
Is it idiopathic?
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Introduction:
• 61-year-old male patient
• History of exercise induced palpitation and frequent
PVCs.
• Her received diagnosis of myocarditis during early
adulthood
• Presyncope and palpitation (12/2019)
• Referred to our centre with documented VT and
presyncope during cycling for further diagnosis.
• External evaluation including TTE (LVEF: 66%) and
coronary angiography were normal (/012020)
• Persistent atrial fibrillation
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Baseline ECG: AF
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Cardiac CMR:
Epicardial scarLVEF: 47%,
LVEDV: 225 ml
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Clinical VT
CL: 330 msQRSd: 155 ms
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Best Pace MappingEarliest Point
LAORAO
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LAORAO
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Spontaneous PVC: scar
associated
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Conclusion:
• VT was induced spontaneously after
Orciprenaline or high rate RV pacing
• VT localized and successfully ablated in RVOT
• No Low-Voltage-Area in RV/RVOT
• During programmed RV/RVOT Stimulation up
to 400-S5 no further sustained and/or non
sustained VT was inducible
• The patient discharged without ICD
• A catheter ablation of AF is planed
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Suggested Reading
Herzschrittmacherther Elektrophysiol. 2017 Jun;28(2):177-186