Catheter Ablation -> Ventricular Arrhythmias -> Mapping & Imaging D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-103 - Myocardial Scar After Retrograde Coronary Venous Ethanol Ablation Of Ventricular Arrhythmias Arising From LV Summit (ID 665)

 S.C. Fuentes Rojas: Nothing relevant to disclose.


Background: Retrograde coronary venous ethanol infusion (RCVEA) can be effective in drug- and radiofrequency (RF)-refractory ventricular arrhythmias (VA) arising from the LV summit. During RCVEA, ethanol infusion reaches the myocardium -visible by contrast staining- but the extent of ablated tissue is unclear.
Objective: We aimed to define the extent and location of ablated tissue after RCVEA of LV summit VA.
Methods: Using EnSite™ Verismo™ software, we performed 3D reconstruction of the late gadolinium-enhanced cardiac magnetic resonance (LGE-CMR) scar that resulted from RCVEA of ventricular arrythmias arising from the LV summit.
Results: Ten patients underwent RCVEA in intramural veins of the anterior interventricular vein with successful VA elimination. LGE-CMR was performed after a median of 40 days (IQR 28-49) from the time of procedure. Five patients had also LGE-CMR before ablation, which served as a comparison. RCVEA of LV summit VT yielded a median of 6.35 cm3of scar (IQR 5.38-7.60) located at the high-septal portion of the outflow tract (Figure).
Conclusion: RCVEA creates a chronic area of myocardial scar that can be delineated by LGE-CMR in the expected areas of ethanol injection. This further validates the RCVEA ablation effectiveness.