Three-dimensional mapping discovered arrhythmic substrate missed in the
initial diagnosis of idiopathic ventricular fibrillation
A 45-year-old man who was diagnosed with idiopathic ventricular
fibrillation (IVF) 12 years ago experienced multiple implantable
cardioverter defibrillator shocks due to ventricular tachycardia (VT).
The recorded electrocardiogram showed VT originating from the right
ventricular outflow tract (RVOT). He underwent catheter ablation for VT,
and 3-dimensional (3D) mapping revealed a low voltage area in the RVOT.
VT was successfully ablated at this site, and his final diagnosis was
scar-related VT, not IVF. We suggest that 3D mapping is useful for the
reassessment of IVF because an arrhythmic substrate might have been
missed in patients who were initially diagnosed with IVF.