Card Electrophysiol Clin. 2026 Sep;18(3):281-287. doi: 10.1016/j.ccep.2026.06.006. Epub 2026 Jul 9.
ABSTRACT
Calcific left ventricular (LV) apical aneurysms represent a highly arrhythmogenic substrate for ventricular tachycardias (VTs), posing unique challenges for mapping and catheter ablation. Dense calcification may obscure electroanatomic signals, hinder catheter stability, and alter conduction channels within scar tissue. We report a case of antiarrhythmic drug-refractory scar VT arising from a calcified LV apical aneurysm successfully treated using intracardiac echocardiogram (ICE) and 3-dimensional electroanatomic mapping guided catheter ablation. High-density substrate mapping revealed fragmented late potentials bordering calcified zones, identifying critical isthmus channels. Targeted ablation under fluoroscopy and ICE successfully terminated the VT and resulted in its noninducibility.
PMID:42580793 | DOI:10.1016/j.ccep.2026.06.006