Impact of Septal Radiofrequency Ventricular Tachycardia Ablation
Insights From Magnetic Resonance Imaging
We present the case of a 38-year-old woman with no past medical history and structurally normal heart with recurrent drug-refractory septal ventricular tachycardia (VT). Despite treatment with flecainide, celiprolol, and sotalol, she experienced breakthrough episodes of VT (Figure 1B). She had undergone 5 failed attempts at VT ablation. She was therefore referred for a further attempt at ablation. Cardiac multidetector computed tomography and late gadolinium enhancement (LGE) MRI were performed before VT ablation. MRI demonstrated nontransmural subendocardial LGE on either side of the septum, which corresponded to previous ablation sites (Figure 2A, Movie I in the online-only Data Supplement).