Key result
Catheter ablation of triggering PVCs yields ~75% freedom from recurrent VF.
Why the study?
The characteristics and ablation targets of VF-triggering PVCs in patients with ischemic cardiomyopathy and electrical storm were not well defined.
Cohort (n=53)
Yes
May offer targeted ablation for refractory VF in ischemic cardiomyopathy; hypothesis-generating pending randomized trials.
We report a case of polymorphic ventricular tachycardia and ventricular fibrillation (PVT/VF) storm associated with ischemic cardiomyopathy (ICM). The electrocardiogram (ECG) monitor revealed frequent premature ventricular contractions (PVCs) initiated PVT/VF. Electroanatomic mapping revealed the plausible origins of PVCs were located in the scar border zone at the posterior septum of the left ventricle. Purkinje-like potentials (PLPs) always preceded PVCs and a decremental property for the PLPs and infarcted myocardium junction was observed. Ablation at these sites eliminated both PVCs and PVT/VF.
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Okada et al. (2007) conducted a cohort in Ventricular fibrillation following acute myocardial infarction (n=53). Catheter ablation was evaluated on Freedom from ventricular fibrillation recurrence. Catheter ablation targeting VF-triggering premature ventricular contractions was effective, with 75% of patients remaining free from ventricular fibrillation recurrence after the final procedure.
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