Epicardial Ablation of Ventricular Tachycardia in Chagas Heart Disease.

Chagas heart disease is a chronic diffuse inflammatory cardiomyopathy with focal aspects. A wide spectrum of cardiac involvement can be found over time and these pathologic aspects determine different clinical presentations of the disease. The peculiar progress of the anatomic substrate may predispose the patient to a progressive cardiomyopathy, complex arrhythmias, and thromboembolic phenomena. Chagas ventricular tachycardia is a reentrant and scar-related tachycardia, and epicardial circuits are frequently found that substrate predominantly related to the inferior and lateral basal walls. Combining endocardial and epicardial mapping and ablation could improve the results of conventional endocardial ventricular tachycardia ablation.