Substrate-based catheter ablation of epicardial ventricular tachycardia related to an anomalous coronary artery

Delayed enhancement magnetic resonance imaging is known for its ability to identify scarred myocardial tissue. This case report describes the use of MR imaging to define the location and transmural extent of infarcted tissue in a 45-year-old woman with an anomalous right coronary artery and hemodynamically unstable ventricular tachycardia. By demonstrating a predominantly epicardial infarct, MR imaging indicated that the pericardial approach was necessary for successful substrate-based ventricular tachycardia ablation.