Fluoroscopy-guided stellate ganglion ablation followed by 3D mapping-guided trigger ablation successfully managed an electrical storm of short-coupled ventricular fibrillation in a young female.
Case Report (n=1)
Stellate ganglion ablation followed by trigger ablation may be an effective strategy for managing electrical storm of short coupled ventricular fibrillation.
We present the case of a young lady with prior implanted ICD presenting with Electrical storm (ES) of short coupled ventricular fibrillation (SCVF). The clinical emergency was managed by a novel technique of fluoroscopy guided stellate ganglion ablation followed by 3D mapping guided trigger ablation. This is to the best of our knowledge the first report of such a malignant phenotype treated by the combination and sequence of these treatment modalities. • Short coupled Ventricular fibrillation is currently accepted terminology for Short coupled PVC induced VF in structurally normal hearts which was previously referred as Idiopathic ventricular fibrillation or Short coupled Torsades . Diagnosis is made my the CASPER Criteria. • Typically PVC causing VF have coupling interval (CI) of 350ms as in our case can initiate life threatening ventricular Tachyarrythmias. • Stellate ganglion Block and ablation may be a effective as a temporary bail -out option in patients with VF and structurally normal hearts. • Automated pace-mapping by quantitative morphology matching software aids in precise identification of triggering ectopy and facilitates and enhances procedural success when activation mapping is not feasible.
Narasimha et al. (Tue,) conducted a case report in Electrical storm of short coupled ventricular fibrillation (SCVF) (n=1). Fluoroscopy guided stellate ganglion ablation followed by 3D mapping guided trigger ablation was evaluated. Fluoroscopy-guided stellate ganglion ablation followed by 3D mapping-guided trigger ablation successfully managed an electrical storm of short-coupled ventricular fibrillation in a young female.