open access

Vol 65, No 3 (2007)
Other
Published online: 2007-03-26
Submitted: 2012-12-28
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Invasive electrophysiology
Ablation of a catecholaminergic polymorphic VT and VF originating from Purkinje fibers – a case report

Łukasz Szumowski, Franciszek Walczak, Andrzej Przybylski, Agnieszka Maryniak, Ewa Szufladowicz, Paweł Derejko, Katarzyna Bieganowska, Robert Bodalski, Michał Orczykowski, Maciej Sterliński, Maria Miszczak-Knecht, Anna Szwed
Kardiol Pol 2007;65(3):319-326.

open access

Vol 65, No 3 (2007)
Other
Published online: 2007-03-26
Submitted: 2012-12-28

Abstract

We describe a case of a 25-year-old woman suffering from recurrent adrenergic polymorphic ventricular tachycardia (PVT). As a 14-year-old the patient suffered from recurrent episodes of syncope during exercise or emotion. On Holter monitoring unsustained runs of PVT were observed. The patient survived SCD (VF) which occurred near the hospital. An ICD was implanted and during the first year over 150 adequate discharges were present. During 9 year follow-up the patient had to have 4 ICDs replaced. She suffered from post-traumatic stress disorder syndrome due to frequent ICD shocks. After age of 23 she was admitted to our hospital and an ablation using the CARTO system was performed. No low voltage areas were observed. During the study ventricular premature beats and VT/PVT runs were observed originating from the Purkinje fibres. RF applications were delivered at those sites, during which abrupt PVT runs were present. After the ablation no ventricular arrhythmia was registered in the ICD memory during 2-year follow-up.

Abstract

We describe a case of a 25-year-old woman suffering from recurrent adrenergic polymorphic ventricular tachycardia (PVT). As a 14-year-old the patient suffered from recurrent episodes of syncope during exercise or emotion. On Holter monitoring unsustained runs of PVT were observed. The patient survived SCD (VF) which occurred near the hospital. An ICD was implanted and during the first year over 150 adequate discharges were present. During 9 year follow-up the patient had to have 4 ICDs replaced. She suffered from post-traumatic stress disorder syndrome due to frequent ICD shocks. After age of 23 she was admitted to our hospital and an ablation using the CARTO system was performed. No low voltage areas were observed. During the study ventricular premature beats and VT/PVT runs were observed originating from the Purkinje fibres. RF applications were delivered at those sites, during which abrupt PVT runs were present. After the ablation no ventricular arrhythmia was registered in the ICD memory during 2-year follow-up.
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Keywords

catecholaminergic polymorphic VT; bi-amplitude VT; VF; triggers and substrate from Purkinje fibres; selective RF ablation; ICD

About this article
Title

Invasive electrophysiology
Ablation of a catecholaminergic polymorphic VT and VF originating from Purkinje fibers – a case report

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 3 (2007)

Pages

319-326

Published online

2007-03-26

Bibliographic record

Kardiol Pol 2007;65(3):319-326.

Keywords

catecholaminergic polymorphic VT
bi-amplitude VT
VF
triggers and substrate from Purkinje fibres
selective RF ablation
ICD

Authors

Łukasz Szumowski
Franciszek Walczak
Andrzej Przybylski
Agnieszka Maryniak
Ewa Szufladowicz
Paweł Derejko
Katarzyna Bieganowska
Robert Bodalski
Michał Orczykowski
Maciej Sterliński
Maria Miszczak-Knecht
Anna Szwed

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