Tachycardia-induced right ventricular cardiomyopathy: epicardial radiofrequency ablation of an unusual and unexpected ventricular tachycardia.

A 38-year-old man without prior medical history was hospitalized for sustained monomorphic ventricular tachycardia (VT) left bundle branch block pattern with inferior QRS axis resistant to beta blockers. Right ventricular (RV) ejection fraction (EF) was 28%. Left ventricular EF was normal. Right and left endocardial ablation failed. Percutaneous epicardial radiofrequency application at the lateral mitral annulus was successful. The RVEF later normalized. Some VTs originating from the left ventricular epicardium are potential mimickers of benign VTs originating from the ventricular outflow tract (right or left) or arrhythmogenic right ventricular cardiomyopathy VT and they may induce isolated RV dysfunction.