Dataset Information

An unusual 'rite of passage' for an ablation catheter during left ventricular tachycardia ablation - a case report.

ABSTRACT:

Introduction

Ventricular perforation during radiofrequency ablation of ventricular tachycardia is a recognized serious complication that carries high morbidity and mortality. Perforation is often associated with local intramyocardial injury due to excess heat induced by catheter, 'steam pop'. The complication usually requires emergency surgical repair.

Case presentation

We present a case, when the catheter found its way into the epicardium during left ventricular (LV) electroanatomic mapping without any serious complication. Angiography through the ablation catheter confirmed the diagnosis of LV coronary sinus fistula.

Discussion

Contrast injection through the irrigation port of the ablation catheter is a useful way of delineating anatomical anomalies during electrophysiology procedure.

SUBMITTER: Ma Y

PROVIDER: S-EPMC6426018 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Publications

An unusual 'rite of passage' for an ablation catheter during left ventricular tachycardia ablation - a case report.

Ma Yuedong Y Chen Zhong Z Shi Rui R Wong Tom T

European heart journal. Case reports 20180124 1

<h4>Introduction</h4>Ventricular perforation during radiofrequency ablation of ventricular tachycardia is a recognized serious complication that carries high morbidity and mortality. Perforation is often associated with local intramyocardial injury due to excess heat induced by catheter, 'steam pop'. The complication usually requires emergency surgical repair.<h4>Case presentation</h4>We present a case, when the catheter found its way into the epicardium during left ventricular (LV) electroanato ...[more]

PMID: 31020088

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Project description:BackgroundThere is paucity of data regarding radiofrequency ablation for ventricular tachycardia (VT) in patients with cardiogenic shock and concomitant VT refractory to antiarrhythmic drugs on mechanical support.MethodsPatients undergoing VT ablation at our center were enrolled in a prospectively maintained registry and screened for the current study (2010-2017).ResultsAll 21 consecutive patients with cardiogenic shock and concomitant refractory ventricular arrhythmia undergoing bailout ablation due to inability to wean off mechanical support were included. Median age was 61 years, 86% were men, median left ventricular ejection fraction was 20%, 81% had ischemic cardiomyopathy, and PAINESD score was 18±5. The type of mechanical support in place before the procedure was intra-aortic balloon pump in 14 patients (67%), Impella CP in 2, extracorporeal membrane oxygenation in 2, extracorporeal membrane oxygenation and intra-aortic balloon pump in 2, and extracorporeal membrane oxygenation and Impella CP in 1. Endocardial voltage maps showed myocardial scar in 19 patients (90%). The clinical VTs were inducible in 13 patients (62%), whereas 6 patients had premature ventricular contraction-induced ventricular fibrillation/VT (29%), and VT could not be induced in 2 patients (9%). Activation mapping was possible in all 13 with inducible clinical VTs. Substrate modification was performed in 15 patients with scar (79%). After ablation and scar modification, the arrhythmia was noninducible in 19 patients (91%). Seventeen (81%) were eventually weaned off mechanical support successfully, but 6 (29%) died during the index admission from persistent cardiogenic shock. Patients who had ventricular arrhythmia and cardiogenic shock on presentation had a trend toward lower in-hospital mortality compared with those who presented with cardiogenic shock and later developed ventricular arrhythmia.ConclusionsBailout ablation for refractory ventricular arrhythmia in cardiogenic shock allowed successful weaning from mechanical support in a large proportion of patients. Mortality remains high, but the majority of patients were discharged home and survived beyond 1 year.

Dataset Information

An unusual 'rite of passage' for an ablation catheter during left ventricular tachycardia ablation - a case report.

Introduction

Case presentation

Discussion

Publications

An unusual 'rite of passage' for an ablation catheter during left ventricular tachycardia ablation - a case report.

Similar Datasets

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