We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Rescue retrograde coronary venous ethanol ablation of ventricular tachycardia storm in a patient with Lamin A/C cardiomyopathy: a case report.
- Authors
Smet, Maarten A J De; Tavernier, Rene; Duytschaever, Mattias; Knecht, Sébastien; Waroux, Jean-Benoît le Polain de
- Abstract
Background Left ventricular (LV) summit arrhythmias account for up to 14% of LV arrhythmias. The ablation of LV summit arrhythmias is challenging, as testified by the fact that radiofrequency (RF) catheter ablation failure is frequent. Retrograde coronary venous ethanol infusion has been proposed as an alternative approach for the ablation of LV summit arrhythmias. Case summary A 47-year-old man with Lamin A/C cardiomyopathy was referred for the ablation of a pleiomorphic ventricular tachycardia (VT) storm, with dominant morphology compatible with LV summit origin. He first received a combined endo- and epicardial RF ablation with the elimination of three clinically relevant VTs. However, the dominant VT could not be ablated due to the proximity of the coronary vasculature and phrenic nerve and remained inducible. Accordingly, an urgent rescue redo procedure consisting of retrograde coronary venous ethanol ablation was performed. Based on the best pace-match and precocity, the first septal, retro-pulmonary branch and the first diagonal branch were infused with ethanol with immediate cessation of the tachycardia and non-inducibility. Anti-arrhythmic drugs were withdrawn, while guideline-directed medical therapy for heart failure was continued. No complications occurred. After 3 months, the patient remained free from any arrhythmias. Discussion Ablation of LV summit arrhythmias is challenging, especially in the context of an electrical storm or in patients with structural heart disease. In such a situation, rescue ablation with retrograde coronary venous ethanol infusion represents an attractive alternative ablation modality.
- Subjects
VENTRICULAR tachycardia; ARRHYTHMIA; BODY surface mapping; CARDIOMYOPATHIES; HEART failure; CARDIAC patients; PHRENIC nerve; ETHANOL
- Publication
European Heart Journal Case Reports, 2024, Vol 8, Issue 5, p1
- ISSN
2514-2119
- Publication type
Article
- DOI
10.1093/ehjcr/ytae235