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Europace Advance Access published online on March 11, 2008
Europace, doi:10.1093/europace/eun051
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

CASE REPORT

Ventricular tachycardia with a myocardial fibre travelling from the origin in the right aortic sinus cusp to the epicardial breakout site of the right ventricular outflow tract

Takumi Yamada*, H. Thomas McElderry, Harish Doppalapudi and G. Neal Kay

Division of Cardiovascular Diseases, University of Alabama at Birmingham, VH B147, 1670 University Boulevard, 1530 3rd AVE S, Birmingham, AL 35294-0019, USA

A 74-year-old man with idiopathic ventricular tachycardia (VT) with a QRS morphology with a left bundle branch block and right inferior axis underwent electrophysiologic testing. Successful ablation was achieved at the right coronary cusp (RCC) where an excellent pace map with long stimulus-to-QRS interval (St-QRS) (85 ms) was obtained. An excellent pace map was also obtained on the epicardial surface ~1 cm away from the successful ablation site and the St-QRS was shorter (40 ms). These findings suggested that a myocardial fibre travelling from the origin in the RCC to the epicardium of the right ventricular outflow tract might exist.

Key Words: Ventricular tachycardia, Aortic sinus cusp, Epicardial, Myocardial fibre, Electrophysiology

* Corresponding author. Tel: +1 205 975 4724; fax: +1 205 975 4720. E-mail address: takumi-y{at}fb4.so-net.ne.jp

Manuscript submitted 15 December 2007. Accepted after revision 13 February 2008.


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