Elective implantable cardioverter-defibrillator removal with extraction of leads following catheter ablation of idiopathic ventricular fibrillation and long-term surveillance

Figures

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  Figure 1. A: Twelve-lead electrocardiogram with sinus arrhythmia and premature ventricular complexes in a pattern of bigeminy. B: Telemetry with initiation of ventricular fibrillation following a premature ventricular complex with a coupling interval of 350 ms. The episode terminated after 22 seconds. C: The patient was the only affected individual on her 3-generation pedigree.

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  Figure 2. Characteristics at the site of successful ablation. A: Best activation map. A Purkinje potential is 30 ms before the QRS complex of the premature ventricular complex on the distal electrode of the map catheter (Map d). A Purkinje potential, fused to the ventricular electrogram, is also present in sinus rhythm. B: Best pace map.

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  Figure 3. A, B: CARTO XP (Biosense Webster, Diamond Bar, CA) electroanatomic activation maps (A: anterior-posterior projection; B: right anterior oblique projection) with location points for the His bundle (yellow), tricuspid valve annulus (light green), and radiofrequency ablation lesions (red). C: Twelve-lead electrocardiogram 1 day after ablation with sinus rhythm and a QRS duration of 76 ms.