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Tachycardiomyopathy a rare manifestation of left ventricular outflow tract tachycardia. Treatment with radiofrequency catheter ablation.

Mora G, Romero N - Indian Pacing Electrophysiol J (2013)

View Article: PubMed Central - PubMed

Affiliation: Associate Professor Department of Internal Medicine, Universidad Nacional de Colombia ; Cardiology Service Fundacion Santafe de Bogota.

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It is recognized that a type of idiopathic ventricular tachycardia (VT) arises from the left ventricular outflow tract (LVOT)... This VT exhibits sustained or nonsustained forms, but also appears as frequent premature ventricular contractions (PVCs) of monomorphic QRS morphology... The prognosis is almost uniformly benign... We describe a patient with tachycardiomyopathy resulting from LVOT VT... The VT could not be entrained (suggesting a non-reentrant mechanism)... The earliest activation in the LVOT was found in aortomitral continuity (Figure 2)... One application of radiofrequency resulted in disappearance of VT. (Figure 3)... Reinduction of VT at baseline and under the effect of isoproterenol did not produce arrhythmias... Interestingly, right ventricular outflow tract (RVOT) and LVOT appear to share the same arrhythmogenic mechanism mediated by triggered activity dependent on delayed after- depolarizations... There were no S waves in lead V6 in any of the groups... The intrinsicoid deflection time in the patients with AMC-VT and anterior MA-VT was significantly greater than that in those with ASC-VT... The origin of tachycardiomyopathy in a ventricular arrhythmia is less common, it has been linked to very frequent premature ventricular contractions, ventricular tachycardia of outflow tract of right ventricle, fascicular tachycardia and bundle-branch reentrant tachycardia... Our patient presents a typical case of tachycardiomyopathy secondary to idiopathic LVOT-VT with full recovery of ventricular function after ablation of the tachycardia focus.

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Electrocardiogram showing VT with atrioventricular dissociation and capture beats
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Figure 1: Electrocardiogram showing VT with atrioventricular dissociation and capture beats

Mentions: An 18 year old man with an incessant monomorphic VT was referred to the electrophysiology service for arrhythmia associated with decreased left ventricular ejection fraction (LVEF). The patient complained of occasional palpitations and was in functional class I. The past history was not significant and physical examination was unremarkable. The electrocardiogram showed wide QRS tachycardia suggestive of VT with a morphology of right bundle branch block (RBBB) and inferior axis (Figure 1). The echocardiogram showed mild left ventricular dilatation and LVEF of 35%. After a written, informed consent was obtained, an electrophysiology study was performed in the postabsortive state and showed incessant monomorphic VT.


Tachycardiomyopathy a rare manifestation of left ventricular outflow tract tachycardia. Treatment with radiofrequency catheter ablation.

Mora G, Romero N - Indian Pacing Electrophysiol J (2013)

Electrocardiogram showing VT with atrioventricular dissociation and capture beats
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539399&req=5

Figure 1: Electrocardiogram showing VT with atrioventricular dissociation and capture beats
Mentions: An 18 year old man with an incessant monomorphic VT was referred to the electrophysiology service for arrhythmia associated with decreased left ventricular ejection fraction (LVEF). The patient complained of occasional palpitations and was in functional class I. The past history was not significant and physical examination was unremarkable. The electrocardiogram showed wide QRS tachycardia suggestive of VT with a morphology of right bundle branch block (RBBB) and inferior axis (Figure 1). The echocardiogram showed mild left ventricular dilatation and LVEF of 35%. After a written, informed consent was obtained, an electrophysiology study was performed in the postabsortive state and showed incessant monomorphic VT.

View Article: PubMed Central - PubMed

Affiliation: Associate Professor Department of Internal Medicine, Universidad Nacional de Colombia ; Cardiology Service Fundacion Santafe de Bogota.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

It is recognized that a type of idiopathic ventricular tachycardia (VT) arises from the left ventricular outflow tract (LVOT)... This VT exhibits sustained or nonsustained forms, but also appears as frequent premature ventricular contractions (PVCs) of monomorphic QRS morphology... The prognosis is almost uniformly benign... We describe a patient with tachycardiomyopathy resulting from LVOT VT... The VT could not be entrained (suggesting a non-reentrant mechanism)... The earliest activation in the LVOT was found in aortomitral continuity (Figure 2)... One application of radiofrequency resulted in disappearance of VT. (Figure 3)... Reinduction of VT at baseline and under the effect of isoproterenol did not produce arrhythmias... Interestingly, right ventricular outflow tract (RVOT) and LVOT appear to share the same arrhythmogenic mechanism mediated by triggered activity dependent on delayed after- depolarizations... There were no S waves in lead V6 in any of the groups... The intrinsicoid deflection time in the patients with AMC-VT and anterior MA-VT was significantly greater than that in those with ASC-VT... The origin of tachycardiomyopathy in a ventricular arrhythmia is less common, it has been linked to very frequent premature ventricular contractions, ventricular tachycardia of outflow tract of right ventricle, fascicular tachycardia and bundle-branch reentrant tachycardia... Our patient presents a typical case of tachycardiomyopathy secondary to idiopathic LVOT-VT with full recovery of ventricular function after ablation of the tachycardia focus.

No MeSH data available.


Related in: MedlinePlus