loading page

Catheter Ablation of Ventricular Tachycardia in LMNA Cardiomyopathy: Out of Sight but not Out of Mind
  • +3
  • Ahmad Halawa,
  • Paul Zei,
  • Neal Lakdawala,
  • William Sauer,
  • Usha Tedrow,
  • Sunil Kapur
Ahmad Halawa
Brigham and Women's Hospital Carl J and Ruth Shapiro Cardiovascular Center
Author Profile
Paul Zei
Brigham and Women's Hospital
Author Profile
Neal Lakdawala
Brigham and Women's Hospital Carl J and Ruth Shapiro Cardiovascular Center
Author Profile
William Sauer
Brigham and Women's Hospital Carl J and Ruth Shapiro Cardiovascular Center
Author Profile
Usha Tedrow
Brigham and Women's Hospital
Author Profile
Sunil Kapur
Brigham and Women's Hospital
Author Profile

Abstract

Lamin Cardiomyopathy (LC) is associated with refractory ventricular arrhythmias. Catheter ablation success rate is low due to presence of multiple circuits and intramural substrate. We present a LC case presented with electrical storm. During catheter ablation, arrhythmia was easily inducible but activation mapping, including full epicardial and endocardial mapping, failed to demonstrate the full tachycardia cycle length (70% only) suggesting intramural activation. Critical isthmus was not identified even with successful concealed entrainment on both Endo/epicardial surfaces. This case shows that even combined endocardial and epicardial catheter approach can be ineffective in identifying the full arrhythmogenic substrate in LC.