Ablation eines idiopathischen "ventrikulären Kolibris"--ventrikuläre Tachykardien aus der Crux cordis
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Ablation eines idiopathischen "ventrikulären Kolibris"--ventrikuläre Tachykardien aus der Crux cordis. / Sultan, A; Lüker, J; Willems, S; Steven, D.
In: DEUT MED WOCHENSCHR, Vol. 139, No. 39, 09.2014, p. 1929-1931.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Ablation eines idiopathischen "ventrikulären Kolibris"--ventrikuläre Tachykardien aus der Crux cordis
AU - Sultan, A
AU - Lüker, J
AU - Willems, S
AU - Steven, D
N1 - © Georg Thieme Verlag KG Stuttgart · New York.
PY - 2014/9
Y1 - 2014/9
N2 - HISTORY AND ADMISSION FINDINGS: A 62-year-old woman presented with history of repeat syncope and palpitations. She experienced aggravation of symptoms within the last few months. At referring hospital a ventricular tachycardia was already inducible during electrophysiological study. The patient was transferred to our hospital for VT ablation vs. ICD implantation.INVESTIGATION: No evidence for structural heart disease was revealed during TTE nor was a coronary heart disease detectable during coronary angiography, only hypertension was verifiable. No ICD implantation so far.TREATMENT AND COURSE: The patient underwent repeat EP study at our facility with induction of VT. Pace-mapping and mapping for earliest ventricular activation was performed. The middle-cardiac vein was revealed as site of earliest ventricular activation (50 ms) and good pace-map. Therefore, radiofrequency ablation at this site terminated successfully VT into sinus rhythm.CONCLUSION: Ablation of epicardial VT foci is successfully feasible via coronary sinus. With regard to typical ECG parameters an epicardial foci may be assumed precociously. The great cardiac vein is one of the most common sites of origin for epicardial foci, however, VT partially may originate from the crux cordis which is accessible for ablation via the middle cardiac vein with good ablation results.
AB - HISTORY AND ADMISSION FINDINGS: A 62-year-old woman presented with history of repeat syncope and palpitations. She experienced aggravation of symptoms within the last few months. At referring hospital a ventricular tachycardia was already inducible during electrophysiological study. The patient was transferred to our hospital for VT ablation vs. ICD implantation.INVESTIGATION: No evidence for structural heart disease was revealed during TTE nor was a coronary heart disease detectable during coronary angiography, only hypertension was verifiable. No ICD implantation so far.TREATMENT AND COURSE: The patient underwent repeat EP study at our facility with induction of VT. Pace-mapping and mapping for earliest ventricular activation was performed. The middle-cardiac vein was revealed as site of earliest ventricular activation (50 ms) and good pace-map. Therefore, radiofrequency ablation at this site terminated successfully VT into sinus rhythm.CONCLUSION: Ablation of epicardial VT foci is successfully feasible via coronary sinus. With regard to typical ECG parameters an epicardial foci may be assumed precociously. The great cardiac vein is one of the most common sites of origin for epicardial foci, however, VT partially may originate from the crux cordis which is accessible for ablation via the middle cardiac vein with good ablation results.
KW - Catheter Ablation
KW - Coronary Vessels/surgery
KW - Defibrillators, Implantable
KW - Electrocardiography
KW - Electrophysiologic Techniques, Cardiac
KW - Female
KW - Heart Ventricles/surgery
KW - Humans
KW - Middle Aged
KW - Signal Processing, Computer-Assisted
KW - Tachycardia, Ventricular/diagnosis
U2 - 10.1055/s-0034-1387311
DO - 10.1055/s-0034-1387311
M3 - SCORING: Zeitschriftenaufsatz
C2 - 25225861
VL - 139
SP - 1929
EP - 1931
JO - DEUT MED WOCHENSCHR
JF - DEUT MED WOCHENSCHR
SN - 0012-0472
IS - 39
ER -
