Key result
A 57-year-old male with dilated cardiomyopathy developed a life-threatening ventricular tachycardia storm the day after undergoing cryoballoon-based pulmonary vein isolation for atrial fibrillation.
Case Report (n=1)
No
Cryoballoon-based pulmonary vein isolation may be associated with a risk of periprocedural life-threatening ventricular arrhythmias, potentially due to the modulation of atrial autonomic innervation.
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Warns of possible post-PVI VT storm in dilated cardiomyopathy; hypothesis-generating and requires prospective study.
BACKGROUND Following catheter ablation of atrial fibrillation, increased incidence of ventricular arrhythmia has been observed. We report a case of sustained ventricular arrhythmia in a patient who underwent cryoballoon-based pulmonary vein isolation for symptomatic persistent atrial fibrillation. CASE REPORT A 57-year-old patient with dilated cardiomyopathy underwent CB-based pulmonary vein isolation for symptomatic persistent AF. On the day following an uneventful procedure, the patient for the first time experienced a sustained ventricular tachycardia that exacerbated into VT storm. Each arrhythmia was terminated by the ICD that had been implanted for primary prevention. Antiarrhythmic treatment with amiodarone was initiated immediately. The patient remained free from sustained ventricular arrhythmia during follow-up. CONCLUSIONS After pulmonary vein isolation, physicians should be vigilant for ventricular arrhythmia. The influence of atrial autonomic innervation on ventricular electrophysiology is largely unknown.
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Münkler et al. (2018) conducted a case report in Symptomatic persistent atrial fibrillation (n=1). Cryoballoon-based pulmonary vein isolation was evaluated on Occurrence of sustained ventricular arrhythmia / VT storm. A 57-year-old male with dilated cardiomyopathy developed a life-threatening ventricular tachycardia storm the day after undergoing cryoballoon-based pulmonary vein isolation for atrial fibrillation.
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