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Europace Advance Access originally published online on April 7, 2009
Europace 2009 11(6):827-830; doi:10.1093/europace/eup067
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

SHORT COMMUNICATIONS

Mitral isthmus pathology of re-entrant ventricular tachycardia in a patient with idiopathic dilated cardiomyopathy

Taka-aki Matsuyama1,*, Takashi Kurita2, Kazuhiro Suyama2, Hideo Okamura2, Takashi Noda2, Kazuhiro Satomi2, Wataru Shimizu2, Naohiko Aihara2, Yoshihiko Ikeda1, Shin Inoue3, Shiro Kamakura2 and Hatsue Ishibashi-Ueda1

1 Department of Pathology, National Cardiovascular Center, 5-7-1 Fujishirodai Suita-City, Osaka 565-8565, Japan; 2 Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Osaka, Japan; 3 Department of Internal Medicine, Showa University Dental Hospital, Tokyo, Japan

A 68-year-old woman with idiopathic dilated cardiomyopathy suffered from drug-resistant monomorphic ventricular tachycardia (VT). Electrophysiological study revealed a re-entrant VT circuit located just beneath the inferior mitral valve annulus. The VT was considered to be related to the mitral valve isthmus and was abolished by radiofrequency ablation. The patient died 2 years after the ablation due to worsening of heart failure and an autopsy was performed. Pathological examination revealed ablation scar tissue on the localized myocardial bundle running parallel to the mitral valve annulus. Therefore, this bundle appeared to comprise the slow conduction area of the re-entrant VT in this case.

* Corresponding author. Tel: +81 6 6833 5012, Fax: +81 6 6833 9865, Email: takamatu{at}hsp.ncvc.go.jp

Manuscript submitted 28 October 2008. Accepted after revision 2 March 2009.


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