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Case Reports in Cardiology
Volume 2011, Article ID 471397, 5 pages
Case Report

Mapping and Surgical Ablation of Focal Epicardial Left Ventricular Tachycardia

1Department of Cardiology, Isala Klinieken Zwolle, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands
2Department of Cardiothoracic Surgery, Isala Klinieken Zwolle, 8011 JW Zwolle, The Netherlands
3Department of Experimental Cardiology, Academic Medical Centre, 1105 AZ Amsterdam, The Netherlands

Received 24 June 2011; Accepted 13 July 2011

Academic Editors: T. Kasai and K. Roberts-Thomson

Copyright © 2011 Arif Elvan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We describe a technical challenge in a 17-year-old patient with incessant epicardial focal ventricular arrhythmia and diminished LV function. Failure of ablation at the earliest activated endocardial site during ectopy suggested an epicardial origin, which was supported by specific electrocardiographic criteria. Epicardial ablation was not possible due to the localization of the origin of the ventricular tachycardia adjacent to the phrenic nerve. Minimal invasive surgical multielectrode high-density epicardial mapping was performed to localize the arrhythmia focus. Epicardial surgical RF ablation resulted in the termination of ventricular ectopy. After 2 years, the patient is still free from arrhythmias.