Nonischemic cardiomyopathy: Simultaneous epicardial and endocardial mapping and ablation

Hongtao Liao, Roderick Tung

Research output: Chapter in Book/Report/Conference proceedingChapter


A 66-year old male with a history of viral myocarditis presented for management of monomorphic ventricular tachycardia (VT). Epicardial and endocardial mapping under RV parahisian paced rhythm showed significant low voltage areas in the free wall of RV. Isochronal late activation map revealed a clear deceleration zone (DZ) on the RV free wall of both epicardium and endocardium. Activation mapping and entrainment during VT identified a clockwise circuit in RV free wall and the isthmus was consistent with the DZ. Epicardial ablation at the isthmus was initially attempted and VT changed in 18 s to another untolerated VT, which ultimately required direct current cardioversion. Combined epicardial and endocardial ablation was performed targeting the DZ. VT was noninducible at the end of the procedure.

Original languageEnglish (US)
Title of host publicationCardiac Electrophysiology
Subtitle of host publicationClinical Case Review
PublisherSpringer International Publishing
Number of pages4
ISBN (Electronic)9783030285333
ISBN (Print)9783030285319
StatePublished - Jan 1 2020
Externally publishedYes


  • Catheter ablation
  • Electroanatomic mapping
  • Nonischemic cardiomyopathy
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Medicine(all)


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