Document Detail

Recurrent polymorphic ventricular tachycardia treated by ablation of Purkinje arborization within an infarct border-zone.
MedLine Citation:
PMID:  21720476     Owner:  NLM     Status:  MEDLINE    
A 70-year-old patient with 3-vessel coronary artery disease and a left ventricular aneurysm underwent coronary artery bypass grafting, together with a surgical anterior ventricular endocardial restoration (SAVER) procedure. Four days later, he suddenly developed recurrent sustained and nonsustained polymorphic ventricular tachycardia, preceded by monomorphic ventricular premature contractions, and did not respond to any antiarrhythmic drug, including lidocaine, esmolol, or amiodarone. Repeated electrical cardioversion procedures were performed (28 in total). Mapping was performed to target the earliest site of activation in the left ventricle during the ventricular premature contractions, a site where the premature beats were preceded by Purkinje potentials. That site was located along a scar border-zone. Ablation at that site resulted in the disappearance of the monomorphic ventricular premature contractions and in the complete suppression of the electrical storm. These findings appear to indicate that the area in which the Purkinje potentials were recorded along the scar border-zone played an important role in the mechanism of the polymorphic ventricular tachycardia after myocardial infarction.
Kyoung-Min Park; Gi-Byoung Nam; Kee-Joon Choi; You-Ho Kim
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  38     ISSN:  1526-6702     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2011  
Date Detail:
Created Date:  2011-07-01     Completed Date:  2011-10-31     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  291-4     Citation Subset:  IM    
Department of Internal Medicine, Sanggye Paik Hospital, University of Inje College of Medicine, Seoul 139-707, Republic of Korea.
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MeSH Terms
Action Potentials
Anterior Wall Myocardial Infarction / complications,  surgery*
Cardiac Surgical Procedures / adverse effects*
Catheter Ablation*
Coronary Artery Bypass / adverse effects
Electrophysiologic Techniques, Cardiac
Heart Aneurysm / complications,  surgery*
Purkinje Fibers / physiopathology,  surgery*
Tachycardia, Ventricular / diagnosis,  etiology,  physiopathology,  surgery*
Treatment Outcome
Ventricular Premature Complexes / diagnosis,  etiology,  physiopathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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