open access

Vol 64, No 7 (2006)
Other
Published online: 2006-07-18
Submitted: 2012-12-28
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Invasive electrophysiology
Eleven-years long follow-up in a patient after myocardial infarction, with low ejection fraction and reccurent ventricular tachycardia. The role of implantable cardioverter defibrillator and selective ablation

Andrzej Przybylski, Paweł Derejko, Marta Iwanek, Piotr Urbanek, Roman Kępski, Jacek Grzybowski, Lidia Chojnowska, Łukasz Szumowski, Hanna Szwed, Franciszek Walczak
Kardiol Pol 2006;64(7):758-762.

open access

Vol 64, No 7 (2006)
Other
Published online: 2006-07-18
Submitted: 2012-12-28

Abstract

The selective ablation of the recurrent ventricular tachycardia (VT) in a 75-year old patient after extensive inferior myocardial infarction (24 years ago), with low ejection fraction was performed. In 1995 the cardioverter-defibrillator was implanted due to recurrent, symptomatic VT. The coronary angiography in 1995 and in 2006 revealed the occlusion of the right coronary and the circumflex arteries. One year after implantation, he had electrical storm caused by proarrhythmic effect of amiodarone with prolongation of QT/QTc interval. During follow up episodes of VT (approximately 5/year) were successfully terminated by ATP and rarely by cardioversion. Recently, the patient was admitted to the hospital because of the very frequent (25/day) episodes of slow (500-560 ms), sustained ventricular tachycardia. The pharmacological treatment was unsuccessful. CARTO mapping and entrainment pacing revealed VT circuit around mitral annulus. A few applications at the paraseptal part of the mitral isthmus terminated VT, which was no longer inducible. During following days there were no VTs requiring ICD interventions.

Abstract

The selective ablation of the recurrent ventricular tachycardia (VT) in a 75-year old patient after extensive inferior myocardial infarction (24 years ago), with low ejection fraction was performed. In 1995 the cardioverter-defibrillator was implanted due to recurrent, symptomatic VT. The coronary angiography in 1995 and in 2006 revealed the occlusion of the right coronary and the circumflex arteries. One year after implantation, he had electrical storm caused by proarrhythmic effect of amiodarone with prolongation of QT/QTc interval. During follow up episodes of VT (approximately 5/year) were successfully terminated by ATP and rarely by cardioversion. Recently, the patient was admitted to the hospital because of the very frequent (25/day) episodes of slow (500-560 ms), sustained ventricular tachycardia. The pharmacological treatment was unsuccessful. CARTO mapping and entrainment pacing revealed VT circuit around mitral annulus. A few applications at the paraseptal part of the mitral isthmus terminated VT, which was no longer inducible. During following days there were no VTs requiring ICD interventions.
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Keywords

myocardial infarction; ventricular tachycardia; electrical storm; implantable cardioverter defibrillator; ablation

About this article
Title

Invasive electrophysiology
Eleven-years long follow-up in a patient after myocardial infarction, with low ejection fraction and reccurent ventricular tachycardia. The role of implantable cardioverter defibrillator and selective ablation

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 64, No 7 (2006)

Pages

758-762

Published online

2006-07-18

Bibliographic record

Kardiol Pol 2006;64(7):758-762.

Keywords

myocardial infarction
ventricular tachycardia
electrical storm
implantable cardioverter defibrillator
ablation

Authors

Andrzej Przybylski
Paweł Derejko
Marta Iwanek
Piotr Urbanek
Roman Kępski
Jacek Grzybowski
Lidia Chojnowska
Łukasz Szumowski
Hanna Szwed
Franciszek Walczak

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