Successful catheter ablation of a ventricular tachycardia storm originating from the left ventricular posterior papillary muscle involved with a remote myocardial infarction.
A 61-year-old man with a remote posterior myocardial infarction underwent electrophysiological testing for a ventricular tachycardia (VT) storm. Repeated cardioversions terminated the VT with immediate resumption after one sinus beat. Pacing neither terminated the VT nor demonstrated transient entrainment. Echocardiographically guided electroanatomic mapping revealed a centrifugal activation from the septal mid-apical region of the left ventricle on the septal portion of the posterior papillary muscle where a high frequency potential was observed within the local ventricular electrogram. Irrigated radiofrequency current at this site eliminated the VT. This case suggested that papillary muscles may be a target for catheter ablation of electrical storms after myocardial infarctions.
Yamada
Takumi
T
Division of Cardiovascular Disease, University of Alabama at Birmingham, VH B147, 1670 University Boulevard, 1530 3rd AVE S, Birmingham, AL 35294-0019, USA. takumi-y@fb4.so-net.ne.jp
Tabereaux
Paul B
PB
Doppalapudi
Harish
H
McElderry
H Thomas
HT
Kay
G Neal
GN
D017115:Catheter Ablation / Q000379:methods*; D006329:Heart Conduction System / Q000601:surgery*; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000601:surgery*; D010210:Papillary Muscles / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome