Utilization of Isochronal Late Activation Mapping to Minimize Ablation Lesion Set in a Patient with Diffuse Epicardial Scar from Non-Ischemic Cardiomyopathy

A 56-year-old male with history of non-ischemic cardiomyopathy underwent endocardial and epicardial catheter ablation procedure for recurrent ventricular tachycardia. Electroanatomic mapping demonstrated extensive scar involving almost the entire right and left ventricular epicardium. Ablation at a site of isochronal “crowding” on the anterior epicardium resulted in termination of the ventricular tachycardia.