Key result
Catheter ablation of premature ventricular contractions successfully suppressed drug-resistant ventricular fibrillation storms in two patients with cardiac amyloidosis, with no further VF recurrences.
Why the study?
Does catheter ablation of PVCs prevent VF recurrences in patients with cardiac amyloidosis and drug-resistant electrical storms?
Case Report (n=2)
Does catheter ablation of PVCs prevent VF recurrences in patients with cardiac amyloidosis and drug-resistant electrical storms?
Catheter ablation of triggering PVCs may be an effective treatment for drug-resistant ventricular fibrillation storms in patients with cardiac amyloidosis.
May warrant consideration in refractory VF storms with cardiac amyloidosis; hypothesis-generating and requires prospective confirmation.
Recent studies have demonstrated that premature ventricular contractions (PVCs) originating from the Purkinje system are responsible for initiation of ventricular fibrillation (VF) in patients with and without structural heart disease. Ablation of the PVCs has been shown to be feasible. We report 2 patients with repetitive VF associated with cardiac amyloidosis. Each episode of ventricular arrhythmia was preceded by monomorphic PVC. The electrical storms were drug resistant. Electrophysiological testing was performed and the sites of earliest activation were localized within the left ventricle in the absence of significant scar tissue. After ablation, PVCs subsided and there were no further VF recurrences.
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Mlcochova et al. (2005) conducted a case report in Ventricular fibrillation storm associated with cardiac amyloidosis (n=2). Catheter ablation was evaluated on Ventricular fibrillation recurrences. Catheter ablation of premature ventricular contractions successfully suppressed drug-resistant ventricular fibrillation storms in two patients with cardiac amyloidosis, with no further VF recurrences.
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