Key result
Aflutter ablation triggers polymorphic VT driven by abrupt rate reduction and prolonged repolarization.
Why the study?
Polymorphic ventricular tachycardia is known after atrioventricular junction ablation for AF, but risk factors and occurrence after ablation for typical atrial flutter have not been investigated.
Case Report (n=1)
Radiofrequency catheter ablation for typical atrial flutter can provoke an abrupt heart rate reduction and profound QTc prolongation, resulting in life-threatening polymorphic ventricular tachycardia.
Answers are grounded in this paper and cite their sources.
May warrant QTc monitoring after flutter ablation in structural heart disease; leaves open true incidence and prevention strategies.
Key Teaching Points•While polymorphic ventricular tachycardia is a life-threatening complication of atrioventricular junction catheter ablation for atrial fibrillation, we describe the first case seen after radiofrequency catheter ablation of typical cavotricuspid-dependent atrial flutter.•Risk factors for the development of ventricular arrhythmias after catheter ablation for atrial flutter have not been investigated; however, similar to atrial fibrillation, they may include dilated cardiomyopathy and structural heart disease.•Prolonged repolarization in the context of an abrupt reduction in heart rate after catheter ablation for atrial flutter should heighten suspicion for the development of malignant ventricular arrhythmias in the periprocedural period. •While polymorphic ventricular tachycardia is a life-threatening complication of atrioventricular junction catheter ablation for atrial fibrillation, we describe the first case seen after radiofrequency catheter ablation of typical cavotricuspid-dependent atrial flutter.•Risk factors for the development of ventricular arrhythmias after catheter ablation for atrial flutter have not been investigated; however, similar to atrial fibrillation, they may include dilated cardiomyopathy and structural heart disease.•Prolonged repolarization in the context of an abrupt reduction in heart rate after catheter ablation for atrial flutter should heighten suspicion for the development of malignant ventricular arrhythmias in the periprocedural period.
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Zada et al. (2019) conducted a case report in Atrial flutter (n=1). Radiofrequency catheter ablation was evaluated on Development of polymorphic ventricular tachycardia. Radiofrequency catheter ablation for atrial flutter induced prolonged repolarization and life-threatening polymorphic ventricular tachycardia due to an abrupt heart rate reduction.
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