scholarly journals Association of Tp-Te/QT Ratio With Ventricular Tachycardia in Patients With Idiopathic Outflow Tract Ventricular Premature Contraction

2018 ◽  
Vol 9 (4) ◽  
pp. 215-223 ◽  
Author(s):  
Arina Prihestri Nugraheni ◽  
Irsad Andi Arso ◽  
Erika Maharani
Author(s):  
Nam Van Tran ◽  
Samuel Rotman ◽  
Patrice Carroz ◽  
Etienne Pruvot

Abstract Background We report an unusual case of non-sustained ventricular tachycardia (NSVT) from the epicardial part of the right ventricular outflow tract (RVOT). Case summary A 37-year-old woman who underwent in 2006 an ablation for idiopathic ventricular premature beats (VPBs) from the RVOT presented with pre-syncopal NSVT in 2016. A cardiac workup showed no coronary disease, normal biventricular function, and no enhancement on cardiac magnetic resonance imaging. A metabolic positron emission tomography scan excluded inflammation. Biopsies revealed normal desmosomal proteins. An endocardial mapping revealed an area of low voltage potential (<0.5 mV) at the antero-septal aspect of the RVOT corresponding to the initial site of ablation from 2006. Activation mapping revealed poor prematurity and pace-mapping showed unsatisfactory morphologies in the RVOT, the left ventricle outflow tract and the right coronary cusp. An epicardial map revealed a low voltage area at the antero-septal aspect of the RVOT with fragmented potentials opposite to the endocardial scar. Pace-mapping demonstrated perfect match. An NSVT was induced and local electrocardiogram showed mid-diastolic potentials. Ablation was applied epicardially and endocardially without any complication. The patient was arrhythmia free at 4-year follow-up. Discussion Cardiac workup allowed to exclude specific conditions such as arrhythmogenic cardiomyopathy, tetralogy of Fallot, sarcoidosis, or myocarditis as a cause for NSVT from the RVOT. The epi and endocardial map showed residual scar subsequent to the first ablation which served as substrate for the re-entrant NSVT. This is the first case which describes NSVT from the epicardial RVOT as a complication from a previous endocardial ablation for idiopathic VPB.


2002 ◽  
Vol 12 (3) ◽  
pp. 294-297 ◽  
Author(s):  
Thomas Paul ◽  
Andrew T. D. Blaufox ◽  
J. Philip Saul

We performed an electrophysiological study, using non-contact mapping, in an 8-year-old girl weighing 39.9 kg who had suffered recurrent symptomatic episodes of exercise-induced non-sustained ventricular tachycardia. Color-coded isopotential maps of the ventricular tachycardia identified the area of earliest endocardial activation high and anterior in the right ventricular outflow tract. Although partial deflation of the balloon was required to position the ablation catheter at the earliest site of activation, this site was still identified accurately, as demonstrated by termination of the ventricular tachycardia and ectopy upon mechanical pressure, as well as application of radiofrequency current.In this young patient, precise mapping of the earliest endocardial activation using the non-contact mapping system was safe and effective, allowing successful radiofrequency ablation of the tachycardia.


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