Catheter ablation for an incessant form of antiarrhythmic drug-resistant ventricular fibrillation after acute coronary syndrome.
A 77-year-old man was admitted with an acute coronary syndrome (ACS), severe heart failure (HF), and repeated ventricular fibrillation (VF) episodes. A single premature ventricular complex (PVC) induced ventricular tachycardia (VT), which degenerated to VF reproducibly. This PVC was eliminated by catheter ablation at the left ventricular posteroseptal region where double Purkinje potentials preceding the ventricular wave had been recorded. The electrical storm disappeared, and programmable stimulation failed to induce any tachyarrhythmias after the ablation. A Purkinje fiber network-related PVC served as a trigger and as a substrate for VT and VF in a case of ACS with HF.
Enjoji
Yoshihisa
Y
Cardiovascular Center, Kyoto Katsura Hospital, Kyoto, Japan. enmomo@nifty.com
Mizobuchi
Masahiro
M
Shibata
Kensaku
K
Yokouchi
Itaru
I
Funatsu
Atsushi
A
Kanbayashi
Daisuke
D
Kobayashi
Tomoko
T
Nakamura
Shigeru
S
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017115:Catheter Ablation; D004351:Drug Resistance; D004562:Electrocardiography; D006801:Humans; D008297:Male; D011690:Purkinje Fibers / Q000601:surgery*; D014693:Ventricular Fibrillation / Q000188:drug therapy / Q000601:surgery*; D018879:Ventricular Premature Complexes / Q000188:drug therapy / Q000601:surgery*
D000889:Anti-Arrhythmia Agents