Successful Noninvasive 12-Lead ECG Mapping-Guided Radiotherapy of Inaccessible Ventricular Tachycardia Substrate Due to Mechanical Valves

Lucas K. Keyt, MD; Todd Atwood, PhD, DABR; Andrew Bruggeman, MD; Arno J. Mundt, MD; Gregory K. Feld, MD; David E. Krummen, MD; Gordon Ho, MD

JACC: Case Reports (Jun 2023)

Successful Noninvasive 12-Lead ECG Mapping-Guided Radiotherapy of Inaccessible Ventricular Tachycardia Substrate Due to Mechanical Valves

Lucas K. Keyt, MD,
Todd Atwood, PhD, DABR,
Andrew Bruggeman, MD,
Arno J. Mundt, MD,
Gregory K. Feld, MD,
David E. Krummen, MD,
Gordon Ho, MD

Affiliations

Lucas K. Keyt, MD: Department of Medicine, Division of Cardiology, University of California San Diego, La Jolla, California, USA
Todd Atwood, PhD, DABR: Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USA
Andrew Bruggeman, MD: Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USA
Arno J. Mundt, MD: Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USA
Gregory K. Feld, MD: Department of Medicine, Division of Cardiology, University of California San Diego, La Jolla, California, USA
David E. Krummen, MD: Department of Medicine, Division of Cardiology, University of California San Diego, La Jolla, California, USA
Gordon Ho, MD: Department of Medicine, Division of Cardiology, University of California San Diego, La Jolla, California, USA; Address for correspondence: Dr Gordon Ho, University of California-San Diego, Cardiology Section 111A, 3350 La Jolla Village Drive, San Diego, California 92161, USA.

Journal volume & issue: Vol. 15
p. 101870

Abstract

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In patients presenting with refractory ventricular tachycardia (VT) and aortic and mitral mechanical prosthetic valves, traditional catheter ablation is challenging. We describe a case in which a novel noninvasive computational electrocardiogram mapping algorithm localized VT sources originating from substrate near the mechanical valves, in which stereotactic ablative radiotherapy eliminated VT in 1.5-year follow-up. (Level of Difficulty: Advanced.)

Published in JACC: Case Reports

ISSN: 2666-0849 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-case-reports

About the journal

Abstract

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