Authors: Petr Peichl Robert Čihák Markéta Koželuhová Dan Wichterle Vlastimil Vančura Josef Kautzner
Publish Date: 2009/11/24
Volume: 27, Issue: 1, Pages: 51-59
Abstract
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 singlecenter experience in catheter ablation of electrical storm caused by focally triggered polymorphic VT/VFCatheter 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 VPBsBased 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 followup 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 reablatedElectrical 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 lifesaving procedure
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