Yonsei Med J.  2011 Nov;52(6):1022-1024. 10.3349/ymj.2011.52.6.1022.

Successful Catheter Ablation of Focal Automatic Left Ventricular Tachycardia Presented with Tachycardia-Mediated Cardiomyopathy

• Lee HW
• Kim JB
• Joung B
• Lee MH
• Kim SS

• KMID: 1058825
• DOI: http://doi.org/10.3349/ymj.2011.52.6.1022

Abstract

Non-reentrant focal tachycardias occur spontaneously, facilitated by catecholamine infusion, but they cannot be initiated or terminated with programmed stimulation. These tachycardias exhibit early activation before the QRS, however, do not typically show the mid-diastolic potential that is crucial for reentrant tachycardia maintenance. Electrophysiological studies are useful for distinguishing focal from macro-reentrant ventricular tachycardia. We report herein a case of patient without a history of structural heart disease who presented with a focal Purkinje ventricular tachycardia and heart failure. The focal Purkinje ventricular tachycardia was eliminated by radiofrequency catheter ablation. All of the patien's symptoms were improved after ablation.

Keyword

Ventricular tachycardia; ventricular dysfunction; catheter ablation

MeSH Terms

Adult
Cardiomyopathies/*surgery
Catheter Ablation/*methods
Humans
Male
Tachycardia, Ventricular/*surgery
Ventricular Dysfunction/surgery

Figure

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  Fig. 1 Twelve-lead ECG upon admission revealed wide QRS tachycardia with RBBB morphology. The QRS axis was -77 degrees, and atrioventricular dissociation was observed. ECG, electrocardiogram; RBBB, right bundle branch block.

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  Fig. 2 Intracardiac-electrogram during ventricular tachycardia. Black arrow indicates Purkinje potential, which was recorded 32 ms before the onset of the QRS.

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  Fig. 3 (A) Chest X-ray taken before discharge. (B) Chest X-ray at outpatient clinic six months after discharge revealed decreased cardiac size.

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