ID 112988
Title Alternative
A successful case of catheter ablation against ventricular tachycardia storm due to old myocardial infarction in a patient with aortic valve replacement
OMI-VT stormに対するカテーテルアブレーション
Author
Takahashi, Mina Tokushima University
Matsumoto, Kazuhisa Tokushima University
Fujimoto, Yuta Tokushima University
Harada, Takafumi Tokushima University
Zheng, Robert Tokushima University
Suto, Kumiko Tokushima University
Saijyo, Yoshihito Tokushima University
Ueno, Rie Tokushima University
Kawabata, Yutaka Tokushima University
Yamada, Nao Tokushima University
Todoroki, Takafumi Tokushima University
Keywords
ventricular tachycardia
storm
old myocardial infarction
catheter ablation
aortic valve replacement
Content Type
Journal Article
Description
A 68-year-old woman with VT storm and frequent appropriate ICD therapy was referred for catheter ablation. Her past history was notable for aortic valve replacement by mechanical valve due to infectious endocarditis 17 years prior to presentation and left ventricular apical old myocardial infarction with unknown onset. At 67 years old, She admitted to the prior hospital due to ventricular tachycardia with LBBB and superior axis at heart rate of 210 per minutes. Administration of amiodarone and magnesium sulfate was ineffective and cardioversion of 200J was successfully terminated the tachycardia. Intra-cardiac defibrillator was implanted and the administration of amiodarone and mexiletine was started. 5 months after, she admitted to the hospital due to the frequent appropriate shock against the same ventricular tachycardia. Administration of lidocaine, sotalol, pilsicainide, and magnesium sulfate could not control the tachycardia and she was referred to our hospital for catheter ablation. During the first session, ventricular tachycardia was easily induced and electroanatomical mapping was performed both during tachycardia and during sinus rhythm. Late diastolic potential preceding the onset of QRS wave by 45ms was detected at the infero-septal side of the apical aneurysm. 7.5s of the RF energy application at this site could terminate the tachycardia and thereafter no ventricular tachycardia was induced. But after dose-reduction or cessation of some anti-arrhythmic drugs, ventricular tachycardia was recurred and second session was performed. This time, no ventricular tachycardia was induced, then we performed isthmus transection and core isolation against the apical aneurysm. Thereafter no ventricular tachycardia was occurred in spite of dose-reduction or cessation of some anti-arrhythmic drugs.
Journal Title
Shikoku Acta Medica
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
74
Issue
5-6
Start Page
201
End Page
208
Sort Key
201
Published Date
2018-12-25
FullText File
language
jpn
TextVersion
Publisher
departments
University Hospital
Medical Sciences