Cardiac magnetic resonance-aided epicardial ventricular tachycardia ablation in post-myocarditis patient

Myocardial scar plays a central role in the genesis and the maintenance of re-entrant arrhythmias associated with ischaemic heart disease, healed myocarditis, and non- ischaemic cardiomyopathies. In these patients, current risk stratification algorithms about sudden death primary prevention and the choice of ICD implantation are LVEF based, leading to the fact that the contemporary rate of appropriated therapies is very low. By contrast, multiple studies reported that LGE at cMR is a strong and specific predictor of VT occurrence and sudden death in post-myocarditis patients. We presented a representative case in which even after the normalisation of LVEF, the extension of LGE, the scar architecture, and the presence of BZCs at cMR analysis are determinants of the arrhythmic risk in a post-myocarditis patient.