Korean Circ J.  2012 Sep;42(9):632-637. 10.4070/kcj.2012.42.9.632.

Catheter Ablation of Ventricular Arrhythmias via the Radial Artery in a Patient With Prior Myocardial Infarction and Peripheral Vascular Disease

• Kim J
• Han D
• Sohn C
• Kim JS
• Park YH

• KMID: 2297896
• DOI: http://doi.org/10.4070/kcj.2012.42.9.632

Abstract

Herein, we present a case of a successful catheter ablation of ventricular tachycardia (VT) using a radial artery approach in a post-myocardial infarction patient, who had an implantable cardioverter-defibrillator and peripheral artery disease. Although the patient did not use antiarrhythmic drugs, the patient experienced no recurrence of VT during the following 3-year period.

Keyword

Catheter ablation; Ventricular tachycardia; Ventricular premature complexes; Radial artery

MeSH Terms

Anti-Arrhythmia Agents
Arrhythmias, Cardiac
Catheter Ablation
Catheters
Defibrillators, Implantable
Humans
Infarction
Myocardial Infarction
Peripheral Arterial Disease
Peripheral Vascular Diseases
Radial Artery
Recurrence
Tachycardia, Ventricular
Ventricular Premature Complexes
Anti-Arrhythmia Agents

Figure

• 

  Fig. 1 Electrocardiograms and angiograms of the patient. A: a 12-lead electrocardiogram of initial ventricular tachycardia had configuration of a left bundle branch block and left axis deviation. B: a 12-lead electrocardiogram after restoration of sinus rhythm. C: extensive calcification of the abdominal aorta and iliac arteries were noted in computed tomography angiography. D: a very tortuous, angulated right common iliac artery is shown.

• 

  Fig. 2 Intracardiac tracings (A) and right and left anterior oblique fluoroscopic image (B and C) mapping of the premature ventricular complex. The surface electrocardiogram, proximal and distal bipolar electrograms from the ablation catheter (Abl p, Abl d), His recording catheter (His p, His d), right ventricular apex (RVA), and arterial pressure are shown from top to bottom. A Purkinje-like potential, preceding QRS onset of PVC by 112 ms, is found in the left ventricular apico-inferior septum. The application of radiofrequency energy at the site abolished PVC in seconds. The A-lead and ICD lead denote atrial and ICD leads, respectively. PVC: premature ventricular complex, ICD: implantable cardioverter-defibrillator.

• 

  Fig. 3 Intracardiac tracings (A) and right and left anterior oblique fluoroscopic images (B and C) of ventricular tachycardia ablation approached from the left radial artery. Surface electrocardiograms, proximal and distal bipolar electrograms from the ablation catheter (Abl p, Abl d) and right ventricular apex (RVA) are displayed from top to bottom. Mid-diastolic potential was recorded prior to the onset of VT by 114 ms and the application of radiofrequency energy terminated the VT within seconds (A). The successful ablation sites (anterolateral left ventricular apex) are shown in B and C. The A-lead and ICD lead denote atrial and ICD leads, respectively. VT: ventricular tachycardia, ICD: implantable cardioverter-defibrillator.

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