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Erschienen in: Journal of Interventional Cardiac Electrophysiology 1/2010

01.01.2010

Catheter ablation of arrhythmic storm triggered by monomorphic ectopic beats in patients with coronary artery disease

verfasst von: Petr Peichl, Robert Čihák, Markéta Koželuhová, Dan Wichterle, Vlastimil Vančura, Josef Kautzner

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 1/2010

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Abstract

Background

Frequent episodes of polymorphic ventricular tachycardias/ventricular fibrillation (VT/VF) in patients with coronary artery disease can be triggered by monomorphic ventricular premature beats (VPBs) and thus, amenable to catheter ablation. The goal of this study was to review single-center experience in catheter ablation of electrical storm caused by focally triggered polymorphic VT/VF.

Methods

Catheter ablation of electrical storm due to focally triggered polymorphic VT/VF was performed in nine patients (mean age, 62 ± 7 years; two females). All patients had previous myocardial infarction (interval of 3 days to 171 months). Mean left ventricular ejection fraction was 27 ± 6%. All patients presented with repeated runs of polymorphic VT/VF triggered by monomorphic VPBs.

Results

Based on mapping data, the ectopic beats originated from scar border zone on interventricular septum (n = 5), inferior wall (n = 3), and lateral wall (n = 1). Catheter ablation was performed to abolish the triggering ectopy and to modify the arrhythmogenic substrate by linear lesions within the infarct border zone. The ablation procedure was acutely successful in eight out of nine patients. During the follow-up of 13 ± 7 months, two patients died due to progressive heart failure. One patient had late recurrence of electrical storm due to ectopic beats of different morphology and was successfully reablated.

Conclusion

Electrical storm due to focally triggered polymorphic VT/VF may occur either in subacute phase of myocardial infarction or substantially later after index event. Catheter ablation of ectopic beats triggering these arrhythmias can successfully abolish electrical storm and become a life-saving procedure.
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Metadaten
Titel
Catheter ablation of arrhythmic storm triggered by monomorphic ectopic beats in patients with coronary artery disease
verfasst von
Petr Peichl
Robert Čihák
Markéta Koželuhová
Dan Wichterle
Vlastimil Vančura
Josef Kautzner
Publikationsdatum
01.01.2010
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 1/2010
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-009-9443-2

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