Successful Catheter Ablation of Electrical Storm After Myocardial Infarction

• DOI: 10.1161/01.cir.0000103701.30662.5c
• Publication Date: 2003-12-09T01:34:03Z
• Authors: Dietmar Bänsch; Feifan Oyang; Matthias Antz; Thomas Arentz; Reinhold Weber; Jesus E. Val-Mejias; Sabine Ernst; Karl-Heinz Kuck
• Keywords: Male; Myocardial Infarction; Middle Aged; 3. Good health; Electrocardiography; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Catheter Ablation; Tachycardia, Ventricular; Humans; Female; Aged; Follow-Up Studies

Background— We report on 4 patients (aged 57 to 77 years; 3 men) who developed drug-refractory, repetitive ventricular tachyarrhythmias after acute myocardial infarction (MI). All episodes of arrhythmias were triggered by monomorphic premature beats (VPBs) with a right bundle-branch block morphology (RBBB). Methods and Results— Left (LV) mapping was performed attempt radiofrequency (RF) ablation the triggering VPBs. Activation clinical VPBs demonstrated earliest activation in anteromedial LV 1 patient inferomedial 2 patients. Short, high-frequency, low-amplitude potentials recorded that preceded onset each extrasystole maximum 126 160 ms. At same site, Purkinje potential documented QRS complex 23 26 ms during sinus rhythm. In patient, only pace attempted identify areas interest LV. Six 30 RF applications abolished all local at site and/or perfect suppressed No episode tachycardia or fibrillation has recurred for 33, 14, 6, 5 months 1, 2, 3, 4, respectively. Conclusions— Incessant MI may be is feasible can prevent drug-resistant electrical storm, even MI. Catheter used as bailout therapy these