title: Catheter ablation of fatal ventricular tachyarrhythmias storm in acute coronary syndrome--role of Purkinje fiber network.
abstract: Ventricular fibrillation (VF) or ventricular tachycardia (VT) storm is a life-threatening arrhythmia. Antiarrhythmic drugs (AADs) are not necessarily effective to rescue life from such conditions. Catheter ablation (CA) targeting triggering premature ventricular contractions (PVCs) of VF or VT that originates from Purkinje fiber network (PFN) is reported to be effective, especially in idiopathic patients. However, in condition of acute coronary syndrome (ACS), the efficacy of CA is not well understood. To clarify the usefulness of CA as an alternative way to AADs, we performed CA in four patients with VF or VT storm. The Purkinje potential was seen just before the myocardial ventricular wave during sinus rhythm that became more prominent and double components during the initiating PVC at the targeted area. Following CA, spontaneous episodes of VF or VT were no longer observed. CA is an efficacious way to bail out PFN-related VF or VT storm even in ACS.
authors.affiliation: Cardiovascular Center, Kyoto Katsura Hospital, 17 Yamada Hirao-Cho, Nishikyo-ku, 615-8256 Kyoto, Japan. enmomo@nifty.com
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Enjoji
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mizobuchi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Muranishi
authors.forename: Chinae
authors.initials: C
authors.lastname: Miyamoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Utsunomiya
authors.forename: Atsushi
authors.initials: A
authors.lastname: Funatsu
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011690:Purkinje Fibers / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000601:surgery*; D016896:Treatment Outcome