title: Clinical effectiveness of pulmonary vein isolation for arrhythmic events in a patient with catecholaminergic polymorphic ventricular tachycardia.
abstract: An 18-year-old woman with catecholaminergic polymorphic ventricular tachycardia (CPVT) underwent pulmonary vein isolation (PVI) because of frequent and inappropriate shocks from an implantable cardioverter defibrillator (ICD) associated with atrial fibrillation (AF) with a rapid ventricular response. While the PVI did not completely suppress the AF induced by an isoproterenol infusion, the Holter monitor recordings demonstrated a major decrease in the clinical episodes of AF and ventricular tachyarrhythmias in association with a reduced high-frequency (HF) component and ratio of the low-frequency (LF) component power to the HF component (LF/HF) after the PVI. The PVI can decrease the substrates that trigger and maintain the AF when it involves a pulmonary vein origin, and may exert an additional effect on the sympathetic nerve input to the heart. The PVI may be an adjunctive therapy for CPVT cases with drug refractory AF causing inappropriate ICD discharges.
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan. naokata@med.nihon-u.ac.jp
authors.forename: Naokata
authors.initials: N
authors.lastname: Sumitomo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Junji
authors.initials: J
authors.lastname: Fukuhara
authors.forename: Toshiko
authors.initials: T
authors.lastname: Nakai
authors.forename: Ichiro
authors.initials: I
authors.lastname: Watanabe
authors.forename: Hideo
authors.initials: H
authors.lastname: Mugishima
authors.forename: Masayasu
authors.initials: M
authors.lastname: Hiraoka
mesh_terms: D000293:Adolescent; D018674:Adrenergic Antagonists / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D002395:Catecholamines / Q000378:metabolism*; D017115:Catheter Ablation; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D018674:Adrenergic Antagonists; D002395:Catecholamines