During catheterization of ventricular tachycardia, it is often found difficult to identify the origin of ventricular tachycardia when tachycardia is not induced during the procedure or hemodynamics are disrupted. Late gadolinium enhancement (LGE) in cardiac MRI and late Iodine enhancement (LIE) in cardiac CT are reportedly performed to identify myocardial scar tissue and estimate the origin of ventricular tachycardia preoperatively. However, although LGE is useful for identifying the origin of tachycardia, the slice thickness is large and imaging takes a long time, and if a premature beat occurs or the device is inserted during imaging, a good image cannot be obtained. On the other hand, LIE also has poor resolution, making it difficult to take clear images. In this case report, the origin of ventricular tachycardia was presumed preoperatively using a new image processing method called Subtraction Myocardial Image for Late Iodine Enhancement (SMILIE) using a 320-row Area Detector CT, which was useful during catheter ablation.
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