Author + information
- Received October 22, 2009
- Accepted November 11, 2009
- Published online September 21, 2010.
- Jordi Estornell-Erill, MD⁎,
- Francisco Ridocci-Soriano, MD, PhD†,
- Aurelio Quesada-Dorador, MD, PhD†,‡,
- Pau Federico-Zaragozá, MD†,
- Oscar Fabregat-Andrés, MD†,
- Victor Palanca-Gil, MD†,‡ and
- Javier Jimenez-Bello, MD†,‡
A 34 year-old male patient with symptomatic left posterior fascicular ventricular tachycardia (A) without structural heart disease underwent a radiofrequency ablation procedure. Radiofrequency energy with high temperature was delivered to the myocardial inferior wall using a cooled-tip ablation catheter. The procedure was finished successfully after 4 h. Although asymptomatic, the patient had Q waves on the electrocardiogram (B) and enzymatic elevation after the procedure. Magnetic resonance imaging performed 2 days after the procedure demonstrated severe hypokinesia in the inferior segments with hypoperfusion at rest (D, arrows; Online Videos 1 and 2) and “doughnut-like” delayed gadolinium enhancement pattern in these segments (E, arrows), specific to microvascular obstruction. A coronary computed tomography scan showed coronary arteries free of disease (C) and hypoenhanced areas in the inferior segments (F, arrows; Online Video 3). A low-dose computed tomography scan acquisition 5 min after iodine contrast administration also demonstrated a doughnut-like delayed enhancement pattern in these segments (G, arrows). ADA = anterior descending artery; CXA = circumflex artery; RCA = right coronary artery.
- Received October 22, 2009.
- Accepted November 11, 2009.
- American College of Cardiology Foundation