Delayed presentation of cardiac perforation after apparently successful catheter ablation for incessant ventricular tachycardia

Radiofrequency catheter ablation of ventricular tachycardia late after myocardial infarction

Radiofrequency catheter ablation is a promising method for controlling ventricular tachycardia (VT) due to prior myocardial infarction. Limitations of mapping and ablation techniques have largely restricted its use to selected patients who have hemodynamically tolerated sustained monomorphic VT that allows catheter mapping. Multiple monomorphologies of VT, which are usually present, often complicate the ablation procedure and interpretation of ablation effects. Ablation is generally restricted to experienced centers and is usually reserved for patients who have failed other therapies. Despite these difficulties, successful ablation can be life-saving in patients with incessant VT and can markedly improve quality of life with frequent shocks from implantable defibrillators.