June 1, 1997Pacing and Clinical Electrophysiology
Right Ventricular Radiofrequency Ablation of Ventricular Tachycardia After Myocardial Infarction
Key result
Right ventricular septal radiofrequency ablation successfully treated ventricular tachycardia in 2 patients with prior myocardial infarction after left ventricular ablation attempts failed.
Why the study?
Does right ventricular septal radiofrequency ablation successfully treat ventricular tachycardia in patients with prior MI and LBBB morphology after failed LV ablation?
Population
2 patients with ventricular tachycardia after prior myocardial infarction, exhibiting left bundle branch…
Design
Case_series
Authors
Discussion
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Implication
May warrant consideration as bailout after failed LV ablation in post-MI VT; leaves open need for prospective validation before broader adoption.
Key Points
- To evaluate the efficacy of right ventricular septal radiofrequency catheter ablation in treating post-infarction ventricular tachycardia following unsuccessful left ventricular ablation.
- Evaluated two patients (N=2) with prior myocardial infarction presenting with drug-refractory ventricular tachycardia.
- Performed right ventricular septal activation mapping after initial radiofrequency energy delivery to the left ventricular endocardium failed to terminate the arrhythmia.
- Both patients exhibited ventricular tachycardia with left bundle branch block morphology and prominent presystolic electrical activity at the right ventricular septum.
- Radiofrequency energy application directly to the right ventricular septum successfully terminated ventricular tachycardia in both instances where left ventricular approaches failed.
Study Design
Type
Case Report (n=2)
Structured PICO
Does right ventricular septal radiofrequency ablation successfully treat ventricular tachycardia in patients with prior MI and LBBB morphology after failed LV ablation?
P
Population
2 patients with ventricular tachycardia and prior myocardial infarction who had failed left ventricular ablation attempts.
I
Intervention
Radiofrequency transcatheter ablation with energy delivery to the right ventricular septum
O
Outcome
Successful ablation of ventricular tachycardia
Right ventricular septal activation mapping and ablation can be successful for ventricular tachycardia with LBBB morphology in patients with prior MI after failed LV ablation.
Cite This Study
Menz et al. (1997) conducted a case report in Ventricular tachycardia after myocardial infarction (n=2). Right ventricular septal radiofrequency transcatheter ablation vs. Left ventricular endocardial ablation (failed attempts) was evaluated on Successful ablation of ventricular tachycardia. Right ventricular septal radiofrequency ablation successfully treated ventricular tachycardia in 2 patients with prior myocardial infarction after left ventricular ablation attempts failed.