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Successful catheter ablation of persistent electrical storm late post myocardial infarction by targeting purkinje arborization triggers.

Thoppil PS, Rao BH, Jaishankar S, Narasimhan C - Indian Pacing Electrophysiol J (2008)

Bottom Line: Drug refractory ventricular tachycardia (VT) occurring as a storm after acute myocardial infarction has grave prognosis.We report a case of a middle-aged lady who presented with drug refractory VT that lead to persistent electrical storm two weeks after an anterior wall myocardial infarction.She underwent a successful catheter ablation of VT followed a few days later by implantation of an AICD.

View Article: PubMed Central - PubMed

Affiliation: Division of Electrophysiology, Department of Cardiology, CARE Hospitals and CARE Foundation, Hyderabad, India.

ABSTRACT
Drug refractory ventricular tachycardia (VT) occurring as a storm after acute myocardial infarction has grave prognosis. We report a case of a middle-aged lady who presented with drug refractory VT that lead to persistent electrical storm two weeks after an anterior wall myocardial infarction. She underwent a successful catheter ablation of VT followed a few days later by implantation of an AICD. Catheter ablation of the VT could control the persistent electrical storm and the patient was free from a recurrence of VT at three month follow up.

No MeSH data available.


Related in: MedlinePlus

Twelve lead ECG during VT (Monomorphic VT, at a rate of 180/mt, RBBB morphology, Northwest axis).
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Figure 1: Twelve lead ECG during VT (Monomorphic VT, at a rate of 180/mt, RBBB morphology, Northwest axis).

Mentions: A 62 years old lady was admitted to an outside facility with evolved anterior wall myocardial infarction and had undergone rescue angioplasty and stenting of single vessel disease in left anterior descending coronary artery (LAD) under cover of Eptifibatide. Ten days after the stenting she developed recurrent episodes of monomorphic VT (at 180/mt, RBBB morphology, North West axis, Figure 1) and presented in an electrical storm unresponsive to multiple antiarrhythmic drugs (IV beta blockers, amiodarone, lidocaine and magnesium), DC shocks, and intraaortic balloon counterpulsation. Overdrive ventricular pacing was performed which was able to restrict VT to around 20 episodes over the previous 24 hr period. The episodes of ventricular tachyarrhythmia were poorly tolerated haemodynamically. An echocardiogram during sinus rhythm had revealed regional wall motion abnormalities in LAD territory and severe LV Dysfunction (LVEF 30%). A check angiogram disclosed a patent stent; there was no thrombus or new lesions. Serum biochemistry, arterial blood gas parameters and thyroid profile were normal. She was referred to our center for feasibility of catheter ablation of VT.


Successful catheter ablation of persistent electrical storm late post myocardial infarction by targeting purkinje arborization triggers.

Thoppil PS, Rao BH, Jaishankar S, Narasimhan C - Indian Pacing Electrophysiol J (2008)

Twelve lead ECG during VT (Monomorphic VT, at a rate of 180/mt, RBBB morphology, Northwest axis).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2572020&req=5

Figure 1: Twelve lead ECG during VT (Monomorphic VT, at a rate of 180/mt, RBBB morphology, Northwest axis).
Mentions: A 62 years old lady was admitted to an outside facility with evolved anterior wall myocardial infarction and had undergone rescue angioplasty and stenting of single vessel disease in left anterior descending coronary artery (LAD) under cover of Eptifibatide. Ten days after the stenting she developed recurrent episodes of monomorphic VT (at 180/mt, RBBB morphology, North West axis, Figure 1) and presented in an electrical storm unresponsive to multiple antiarrhythmic drugs (IV beta blockers, amiodarone, lidocaine and magnesium), DC shocks, and intraaortic balloon counterpulsation. Overdrive ventricular pacing was performed which was able to restrict VT to around 20 episodes over the previous 24 hr period. The episodes of ventricular tachyarrhythmia were poorly tolerated haemodynamically. An echocardiogram during sinus rhythm had revealed regional wall motion abnormalities in LAD territory and severe LV Dysfunction (LVEF 30%). A check angiogram disclosed a patent stent; there was no thrombus or new lesions. Serum biochemistry, arterial blood gas parameters and thyroid profile were normal. She was referred to our center for feasibility of catheter ablation of VT.

Bottom Line: Drug refractory ventricular tachycardia (VT) occurring as a storm after acute myocardial infarction has grave prognosis.We report a case of a middle-aged lady who presented with drug refractory VT that lead to persistent electrical storm two weeks after an anterior wall myocardial infarction.She underwent a successful catheter ablation of VT followed a few days later by implantation of an AICD.

View Article: PubMed Central - PubMed

Affiliation: Division of Electrophysiology, Department of Cardiology, CARE Hospitals and CARE Foundation, Hyderabad, India.

ABSTRACT
Drug refractory ventricular tachycardia (VT) occurring as a storm after acute myocardial infarction has grave prognosis. We report a case of a middle-aged lady who presented with drug refractory VT that lead to persistent electrical storm two weeks after an anterior wall myocardial infarction. She underwent a successful catheter ablation of VT followed a few days later by implantation of an AICD. Catheter ablation of the VT could control the persistent electrical storm and the patient was free from a recurrence of VT at three month follow up.

No MeSH data available.


Related in: MedlinePlus