Key result
Ethanol ablation of the first septal perforator terminates incessant slow VT after failed RF attempts.
Why the study?
Conventional radiofrequency ablation can fail to eliminate ventricular tachycardia originating from thick ventricular septal tissue, creating a need for alternative approaches.
Case Report (n=1)
Ethanol ablation of septal perforators may serve as a successful bailout strategy for septal ventricular tachycardias refractory to various radiofrequency ablation modalities.
May offer bailout for refractory septal VT after failed RF; leaves open safety and durability in larger cohorts.
Ablation of ventricular tachycardia (VT) by conventional radiofrequency ablation can be impossible if the ventricular wall at the targeted ablation site is very thick, as for example the ventricular septum. We present a case of a patient with incessant, non-sustained slow VT originating from the septal part of the lower outflow tracts. Radiofrequency catheter ablation from both ventricles as well as from the anterior cardiac vein were not successful. Both high power radiofrequency ablation and bipolar radiofrequency ablation neither were successfull. Finally, ethanol ablation of the first septal perforator successfully terminated arrhythmia. We discuss the possibilities to overcome failed conventional radiofrequency VT ablation of a septal focus.
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Roten et al. (2012) conducted a case report in Incessant, non-sustained slow ventricular tachycardia (n=1). Ethanol ablation of the first septal perforator vs. Conventional radiofrequency ablation was evaluated on Termination of arrhythmia. Ethanol ablation of the first septal perforator successfully terminated incessant, non-sustained slow ventricular tachycardia after multiple failed radiofrequency ablation attempts.
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