A successful electrical ablation of recurrent sustained ventricular tachycardia in a postoperative case of tetralogy of Fallot

Japanese Heart Journal
H OdaS Eguchi

Abstract

A 26 year old female patient developed recurrent sustained ventricular tachycardia (VT) after undergoing heart surgery for the third time for chronic pulmonary regurgitation following repair of tetralogy of Fallot. At the last surgery, ventriculotomy was again performed in the outflow tract of the right ventricle. At that time, scar formation and thinning of the cardiac wall were obvious. The surgical result was excellent. Three months later, she lost consciousness. ECG showed VT which was refractory to tolerated doses of antiarrhythmic drugs. Electrophysiologic study showed fragmented activity in the outflow tract of the right ventricle during VT which could be induced and terminated by programmed electrical stimulations. DC energy delivery of 200 Joules to catheter electrodes which recorded local activity 20 msec prior to the onset of the QRS of VT was successful in preventing VT. VT could not be induced by extensive programmed stimulation 1 month later.

Citations

Oct 1, 1986·Journal of Electrocardiology·Y AizawaA Shibata
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·James G MorwoodEdward P Walsh
Jul 1, 1991·American Heart Journal·S NiwanoA Shibata
Jul 26, 2013·Circulation. Arrhythmia and Electrophysiology·Jeremy P MooreMichael C Fishbein

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