Work

Ultra–High Density Mapping of Ventricular Tachycardia in a Patient With Arrhythmogenic Right Ventricular Cardiomyopathy

Year: 2025

Type: article

Abstract: BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiomyopathy that often leads to ventricular dysfunction and recurrent ventricular tachycardia (VT). Catheter ablation is a beneficial treatment for ARVC-related VT, but extensive substrate ablation may increase the risk of iatrogenic hemodynamic decompensation. CASE SUMMARY: We describe a 54-year-old female ARVC patient with paroxysmal palpitations and frequent implantable cardioverter-defibrillator discharges. DISCUSSION: This case demonstrates that ultra-high density mapping-guided precise ablation can effectively target the "culprit" substrate in ARVC patients with extensive ventricular scarring, achieving a favorable balance between long-term freedom from VT and preservation of residual cardiac function. TAKE-HOME MESSAGES: Precise ablation balances efficacy and safety by ensuring long-term VT freedom and preserving residual cardiac function in ARVC patients. Comprehensive mapping techniques, including activation mapping, entrainment mapping, and isochronal late activation mapping, improve ablation accuracy.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.106213