Electroanatomical mapping-assisted surgical treatment of incessant ventricular tachycardia associated with an intramyocardial giant lipoma

Excerpt

Primary cardiac tumors are extremely rare. Cardiac tumors produce various signs and symptoms due to mechanical compression or bulging of the ventricles [1, 2]. One of the signs is ventricular tachycardia (VT), a life-threatening condition that requires aggressive management. Surgical resection of the tumor is the preferred treatment for VT [3‐5]. However, complete surgical resection is not feasible in some cases in which the tumor infiltrates deeply into the cardiac structures. On the other hand, there is possibility that a minimally invasive procedure, such as focal ablation or partial resection, will treat the VT when the tumor is benign and the mechanism of VT is localized. However, in a case in which catheter ablation therapy fails, the mechanism of VT may involve the stretched myocardium around the tumor, especially on the tumor surface. We report a surgical case of incessant VT associated with a giant intramyocardial lipoma. The epicardial electrical activities over the tumor were examined using a cardiac electroanatomical mapping (CARTO) system intraoperatively prior to the surgical procedure. …