Key result
Focal ablation of trigger premature ventricular complexes successfully suppressed idiopathic ventricular fibrillation but was complicated by T-wave oversensing and repetitive shocks during exercise.
Case Report (n=1)
T-wave oversensing and inappropriate ICD shocks can occur as a complication shortly after successful ablation of malignant Purkinje ectopy.
T-wave oversensing may complicate post-ablation ICD management in idiopathic VF; case report extends awareness but leaves open preventive strategies.
Focal ablation of trigger premature ventricular complexes (PVCs) from the Purkinje system helped to suppress idiopathic ventricular fibrillation (VF) in an athlete who had suffered from frequent appropriate shock therapies. However, only a few days after successful ablation T-wave oversensing occurred during exercise and resulted in repetitive distressing defibrillator shocks. Despite lack of any changes on the surface ECG, the endocardially recorded electrogram revealed an unfavorable ratio of R-to-T-wave amplitude predisposing to double counting with accelerated heart rates. This case illustrates that T-wave oversensing may complicate the clinical course after successful ablation of malignant Purkinje ectopy.
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Strohmer et al. (2006) conducted a case report in Idiopathic ventricular fibrillation (n=1). Focal ablation of trigger premature ventricular complexes was evaluated on T-wave oversensing and repetitive defibrillator shocks. Focal ablation of trigger premature ventricular complexes successfully suppressed idiopathic ventricular fibrillation but was complicated by T-wave oversensing and repetitive shocks during exercise.
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