Key result
RF ablation resolves fascicular VT in a post-myocarditis case with no recurrence at 1 year.
Why the study?
Idiopathic ventricular tachycardia is rare in viral myocarditis, and there were no prior reports detailing the treatment of idiopathic ventricular tachycardia complicated by viral myocarditis.
Does radiofrequency ablation prevent recurrence of fascicular ventricular tachycardia in a patient with prior viral myocarditis?
Case Report (n=1)
Does radiofrequency ablation prevent recurrence of fascicular ventricular tachycardia in a patient with prior viral myocarditis?
Radiofrequency ablation successfully treated fascicular ventricular tachycardia that developed after viral myocarditis in a young male patient, with no recurrence at 1 year.
Supports ablation feasibility in post-myocarditis fascicular VT; hypothesis-generating and requires prospective validation before practice change.
RATIONALE: Viral myocarditis is more common in clinical practice with arrhythmia, but it is rare to have idiopathic ventricular tachycardia. Literature review shows that there are no reports on the treatment of idiopathic ventricular tachycardia complicated by viral myocarditis. PATIENTS CONCERNS: The patient is a 19-year-old young man who developed chest tightness and chest pain after catching a cold on April 14, 2021, which lasted for 2 days. The electrocardiogram showed sinus rhythm with ST-T change. The high-sensitivity cardiac troponin test result was 0.06 ng/mL, and the cardiac color ultrasound examination found no obvious structural and functional abnormalities. DIAGNOSES: viral myocarditis; fascicular ventricular tachycardia. INTERVENTIONS: After 10 days of myocardial nutritional support treatment, the high-sensitivity cardiac troponin T test result was 0.004 ng/mL. Long-term follow-up was conducted after discharge, and as of December 2021, the reexamination indicators showed normal. However, in March 2023, the patient went to the hospital again due to palpitation and underwent an electrocardiogram. The electrocardiogram waveform showed wide Q wave-R wave-S wave complex ventricular tachycardia and complete right bundle branch block with left posterior fascicular block, and was diagnosed as fascicular ventricular tachycardia. Tachycardia, after cardiac electrophysiological examination and radiofrequency ablation treatment. OUTCOMES: The patient was no recurrence occurred during the 1 year follow-up, and the 24-hour ambulatory electrocardiogram showed sinus rhythm. LESSONS: In clinical work, arrhythmia is common in patients with viral myocarditis, but cases of idiopathic branched ventricular tachycardia are rare, which may lead to a relative lack of understanding of the disease and is easily associated with supraventricular tachycardia with intraventricular differential conduction. Confusion, clinically is necessary to collect more relevant cases to analyze and explore its related mechanisms and treatments. At the same time, after treatment for children and adolescents with myocarditis, follow-up electrocardiograms can be used to avoid the occurrence of malignant arrhythmias.
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Liu et al. (2025) conducted a case report in Viral myocarditis and fascicular ventricular tachycardia (n=1). Radiofrequency ablation was evaluated on Recurrence of tachycardia. Radiofrequency ablation successfully treated fascicular ventricular tachycardia in a 19-year-old male with a history of viral myocarditis, with no recurrence during a 1-year follow-up.
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