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- Title
Noncoronary ST Elevation and Polymorphic Ventricular Tachycardia During Left-Sided Accessory Pathway Ablation.
- Authors
HWANG, GYO‐SEUNG; PARK, JIN‐SUN; YANG, HYOUNG‐MO; LIM, HONG‐SEOK; CHOI, BYOUNG‐JOO; CHOI, SO‐YEON; YOON, MYEONG‐HO; SHIN, JOON‐HAN; TAHK, SEUNG‐JEA
- Abstract
Noncoronary ST Elevation During Ablation Therapy Introduction An early repolarization (ER) pattern on electrocardiogram (ECG) sometimes has the risk of polymorphic ventricular tachycardia (PVT) or ventricular fibrillation (VF). An abnormal ER pattern can develop in various experimental or clinical situations. We experienced 4 cases of abnormal ER pattern with or without PVT during the radiofrequency (RF) ablation of the left accessory pathway. Methods and Results An electrophysiologic study and RF ablation were performed in 4 patients. Four patients had atrioventricular reentrant tachycardia. During RF ablation of the left accessory pathway, severe chest pain developed and was followed by abnormal J-point elevation. During the ongoing chest pain and J-point elevation, coronary angiograms showed normal findings. The chest pain and J-point elevation were followed by PVT or VF that was unresponsive to defibrillation. The PVT was spontaneously terminated and repeated. After 0.5 mg atropin was given, chest pain and ECG change disappeared. Conclusion The mechanisms of ER syndrome during RF ablation might be increased vagal tone due to chest pain or direct vagal stimulation.
- Subjects
CATHETER ablation; CHEST pain; ELECTROCARDIOGRAPHY; NEURAL stimulation; VAGUS nerve; VENTRICULAR fibrillation; VENTRICULAR tachycardia
- Publication
Journal of Cardiovascular Electrophysiology, 2013, Vol 24, Issue 11, p1240
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.12217