Pushing the Limits: Successful Zero Fluoroscopy Ventricular Tachycardia Ablation With Intraventricular Thrombus Guided by Intracardiac Echocardiography.

ABSTRACT:

Case summary

A 77-year-old man with a history of ischemic cardiomyopathy and apical aneurysm presented with a ventricular tachycardia (VT) storm that was refractory to multiple antiarrhythmic drugs. Transthoracic echocardiography revealed left ventricular ejection fraction of 15% and a well-defined layered thrombus. After discussing risks and benefits, the patient underwent VT ablation guided by intracardiac echocardiography. Electroanatomic mapping localized the critical VT isthmus to the middle portion of the ischemic scar. Clinical VT was successfully suppressed with ablation, and the patient was discharged with no acute complications.

Discussion

VT ablation in the presence of an intracavitary thrombus is an uncommon procedure due to the potential risk of thromboembolic e

SUBMITTER: Sanhueza E 

PROVIDER: S-EPMC12441509 | biostudies-literature | 2025 Jul

REPOSITORIES: biostudies-literature