Abolition of Torsade de Pointes after radiofrequency catheter ablation at right ventricular outflow tract.
Radiofrequency (RF) catheter ablation was tried to treat a patient with syncope, perhaps due to polymorphic ventricular tachycardia (VT) of Torsade de Pointes (TdP) type which was documented by Holter monitoring. Electrophysiological study showed that the isolated ventricular extrasystoles (VEs) that initiated TdP were exactly replicated by pace mapping at the septal site of the right ventricular outflow tract. Performance of RF ablation at this site abolished the TdP and episodes of syncope with no requirement for antiarrhythmic agents for 3 years, whereas isolated VEs persisted. Although it is difficult to mention whether RF ablation was successful or not in this case, this procedure should be considered as a potentially curative approach to the TdP, when the arrhythmogenic focus can be fixed and identified as in this case.
Ashida
K
K
The First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Higashi-ku, Fukuoka, Japan.
Kaji
Y
Y
Sasaki
Y
Y
D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D018780:Body Surface Potential Mapping; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D015716:Electrocardiography, Ambulatory; D005260:Female; D006346:Heart Septum / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D011664:Pulmonary Valve / Q000601:surgery; D013575:Syncope / Q000503:physiopathology; D016171:Torsades de Pointes / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000601:surgery
D000889:Anti-Arrhythmia Agents