1. Introduction
Malignant ventricular arrhythmia accounts for 44% of deaths due to left
ventricular aneurysm (LVA).1Coronary artery bypass grafting
(CABG) combined resection or formation of LVA are the main treatments
for LVA, but the postoperative sudden cardiac death caused by malignant
ventricular arrhythmia accounted for 29.6% and 36.8% of 30-day and
5-year-death
respectively.2In particular, radiofrequency catheter ablation (RFCA) assisted by a
three-dimensional electroanatomical mapping (3D EAM) system is used to
treat ventricular arrhythmia following the acute myocardial infarction
(MI). However, there are still
lack of appropriate electrophysiological mapping and transwall RF for
resolving ventricular arrhythmia during surgery due to reentry loop and
ectopic pacemaker presented in the endocardium, epicardium or myocardial
tissue. This report describes the case of a patient with refractory
ventricular tachycardia (VT) secondary to LVA, whose treatment with
unipolar RFCA was ineffective. We hypothesized that bipolar RFCA
assisted by CARTO mapping, one of 3D EAM, would effectively treat
refractory VT caused by LVA or scar after MI. Consequently, the patient
underwent CABG with bipolar RFCA assisted by CARTO mapping with good
postoperative outcomes.