Catheter ablation of a monofocal premature ventricular complex triggering idiopathic ventricular fibrillation.
A 62 year old man was admitted for evaluation of recurrent episodes of syncope. A surface ECG showed frequent repetitive premature ventricular complexes of right ventricular outflow tract origin. Ventricular fibrillation was inducible by programmed electrical stimulation but otherwise cardiac evaluation was unremarkable. A diagnosis of idiopathic ventricular fibrillation was made and an implantable cardioverter-defibrillator (ICD) was installed. However, spontaneous ventricular fibrillation recurred, requiring repeated ICD discharges. The ventricular fibrillation was reproducibly triggered by a single premature ventricular complex with a specific QRS morphology. Radiofrequency catheter ablation was carried out to eradicate this complex. No ventricular fibrillation has developed after this procedure, and the patient does not require drug treatment.
Takatsuki
S
S
Division of Cardiology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
Mitamura
H
H
Ogawa
S
S
D017115:Catheter Ablation; D017147:Defibrillators, Implantable; D006801:Humans; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000209:etiology / Q000601:surgery / Q000628:therapy; D014693:Ventricular Fibrillation / Q000150:complications / Q000601:surgery* / Q000628:therapy