The ventricular reentry circuits commonly found in Chagas'Disease(CD) frequently originate ventricular tachycardia(VT) that can lead to the patient's death. Most of this arrhythmia is drug-resistant. A new surgical technique was used on 9 patients, with VT and CD. 8 had aneurysms in the apical and 1 in the infero-basal portion of the left ventricle. Ages ranged from 34-62 (mean 48), with five females. All patients were classified as functional class III and IV (NYHA), and most presented syncope associated with VT. During surgery, clinical tachycardias were induced by programmed ventricular pacing and were interrupted by endocardial touch mapping, using a surgical instrument in the region of probable origin of tachycardia. Previous morphology registered on the 12 leads surface EKG oriented by its. In that and its surrounding area, radiofrequence was applied using a 7f ablation catheter. The patients did not require any antiarrhythmic drugs and were followed up for 13+/-7 months; eight are in good status, asymptomatic and in functional class I and II, without any tachycardia; one died from lung disease three months later without tachycardia during this period. This technique is simple, reproducible and achieves a high rate of success (100% in our series) and does not require sophisticated electrophysiological personnel and facilities.
Tachycardia; Catheter ablation; Chagas cardiomyopathy
