Catheter Ablation for Electrical Storm as Polymorphic Ventricular Tachycardia in a Case with Ischemic Cardiomyopathy after Coronary Artery Bypass Graft

• Main Authors: Yasuhiro Yoshiga, MD, Akihiko Shimizu, MD, Shinsuke Suzuki, MD, Naoki Sugi, MD, Toshihide Omiya, MD, Makoto Ono, MD, Masaaki Yoshida, MD, Masunori Matsuzaki, MD
• Format: Article
• Language: English
• Published: Wiley 2010-01-01
• Series: Journal of Arrhythmia
• Subjects: Polymorphic ventricular tachycardia; Radiofrequency catheter ablationPurkinje fiber; Ischemic heart disease; Coronary artery bypass graft
• Online Access: http://www.sciencedirect.com/science/article/pii/S1880427610800195

We report a case involving a patient with ischemic cardiomyopathy who developed polymorphic ventricular tachycardia (PVT) and ventricular fibrillation storm after coronary artery bypass graft. Because PVT was initiated by various right bundle branch type premature ventricular contractions (PVCs), we assessed the relatively monomorphic ventricular tachycardia (MVT) during PVT. Electroanatomical mapping revealed that the earliest ventricular activation of the MVT was located in the scar border zone at the posterior septum of the left ventricle. Stable potentials which preceded the MVT were observed. Catheter ablation for the preceding potential suppressed the maintenance of the PVT, although triggered PVCs appeared frequently. Catheter ablation was effective as a bailout therapy in a patient with PVT-induced cardiomyopathy after cardiac operation.