Storm of Short Coupling Polymorphic Ventricular Tachycardia Triggered by Ventricular Ectopy from Distal Purkinje System: Management and Outcome

Authors

  • Alexander Chapurnykh Department of Surgical Treatment of Complex Cardiac Arrhythmias and Cardiac Pacing. Central Clinical Hospital of the Management Department of the President of the Russian Federation
  • Sergey Lakomkin Department of Surgical Treatment of Complex Cardiac Arrhythmias and Cardiac Pacing. Central Clinical Hospital of the Management Department of the President of the Russian Federation
  • Vladimir Niznichenko Department of Surgical Treatment of Complex Cardiac Arrhythmias and Cardiac Pacing. Central Clinical Hospital of the Management Department of the President of the Russian Federation

DOI:

https://doi.org/10.12970/2311-052X.2019.07.01

Keywords:

 Horse, cervical spine, mobilisation, physiotherapy, ROM.

Abstract

Background: Storm of short coupling PVT (SC PVT) is a rear clinical syndrome. Implantable cardioverter-defibrillator and radiofrequency ablation of arrhythmia trigger are optional for life threatening control and freedom from arrhythmia.

Method and Result: This case report describes a 50-year-old woman with normal repolarization duration who survived multiple electrical storms and cardiac arrest related to recurrent SC PVT. Betablocker and amiodarone suppressed storm of PVT and cardioverter defibrillator was implanted. After than radiofrequency ablation of premature ventricular contraction – trigger of PVT was performed.

Result: Radiofrequency ablation revealed high efficacy in long term prevention of recurrence of PVC triggering PVT and VF.

References

Priori SG, Blomstrom-Lundqvist C, Mazzanti A, et al. ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Europace 2015; 17: 1601-87.

Haïssaguerre M, Shoda M, Jaïs P, et al. Mapping and Ablation of Idiopathic Ventricular Fibrillation. Circulation 2002; 106: 962-967. https://doi.org/10.1161/01.CIR.0000027564.55739.B1

Cronin EM, Bogun FM, et al. HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias. Europace 2019; 21(8): 1143-1144. https://doi.org/10.1093/europace/euz132

Aliot EM, Stevenson WG, Almendral-Garrote JM, et al. EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias 2009 Heart Rhythm Society and the European Heart Rhythm Association. Heart Rhythm 2009; 6(6): 886-933. https://doi.org/10.1016/j.hrthm.2009.04.030

Nayyar S, Ganesan AN, Brooks AG, et al. Venturing into ventricular arrhythmia storm: a systematic review and metaanalysis. Eur Heart J 2013; 34(8): 560-571. https://doi.org/10.1093/eurheartj/ehs453

Wolfe CL, Nibley C, Bhandari A, et al. Polymorphous ventricular tachycardia associated with acute myocardial infarction. Circulation 1991; 84(4): 1543-51. https://doi.org/10.1161/01.CIR.84.4.1543

Viskin S, Belhassen B. Polymorphic ventricular tachyarrhythmias in the absence of organic heart disease: classification, differential diagnosis, and implications for therapy. Prog Cardiovasc Dis 1998; 41(1): 17-34. https://doi.org/10.1016/S0033-0620(98)80020-0

Richter S, Gebauer R, Hindricks G, Brugada P. A classic electrocardiographic manifestation of catecholaminergic polymorphic ventricular tachycardia. J Cardiovasc Electrophysiol 2012; 23(5): 560. https://doi.org/10.1111/j.1540-8167.2011.02138.x

Goldenberg I, Horr S, Moss AJ, et al. Risk for life-threatening cardiac events in patients with genotype-confirmed long-QT syndrome and normal-range corrected QT intervals. J Am Coll Cardiol 2011; 57: 51-59. https://doi.org/10.1016/j.jacc.2010.07.038

Vincent GM, Timothy KW, Leppert M, Keating M. The spectrum of symptoms and QT intervals in carriers of the gene for the long-QT syndrome. N Engl J Med 1992; 327: 846-852. https://doi.org/10.1056/NEJM199209173271204

Ohno S, Zankov DP, Ding WG, et al. KCNE5 (KCNE1L) variants are novel modulators of Brugada syndrome and idiopathic ventricular fibrillation. Circ Arrhythm Electrophysiol 2011; 4: 352-361. https://doi.org/10.1161/CIRCEP.110.959619

Fujii Y, Itoh H, Ohno S, et al. A type 2 ryanodine receptor variant associated with reduced Ca2+ release and shortcoupled torsades de pointes ventricular arrhythmia. Heart Rhythm 2017; 14: 98-107. https://doi.org/10.1016/j.hrthm.2016.10.015

Scheinman MM. Role of the His-Purkinje system in the genesis of cardiac arrhythmia. Heart Rhythm 2009; 6: 1050- 1058. https://doi.org/10.1016/j.hrthm.2009.03.011

Boyden PA, Pu J, Pinto JMB, et al. Ca2+ waves in Purkinje cells. Role in action potential initiation. Circ Res 2000; 86: 448-455. https://doi.org/10.1161/01.RES.86.4.448

Shiga T, Shoda M, Matsuda N, et al. Electrophysiological characteristic of a patient exhibiting the short-coupled variant of torsade de pointes. J Electrocardiol 2001; 34: 271-275. https://doi.org/10.1054/jelc.2001.24380

Bogaard K, van der Steen MS, Tan HL, Tukkie R. Shortcoupled variant of torsade de pointes. Netherlands Heart Journal 2008; 16(7/8): 246-249. https://doi.org/10.1007/BF03086155

Marrouche NF, Verma A, Wazni O, et al. Mode of initiation and ablation of ventricular fibrillation storms in patients with ischemic cardiomyopathy. J Am Coll Cardiol 2004; 43(9): 1715-1720. https://doi.org/10.1016/j.jacc.2004.03.004

Anderson JL, Rodier HE, Green LS. Comparative effects of beta-adrenergic blocking drugs on experimental ventricular fibrillation threshold. Am J Cardiol 1983; 51(7): 1196-1202. https://doi.org/10.1016/0002-9149(83)90368-5

Zipes DP, Camm AJ, Borggrefe M, Buxton AE, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol 2006; 48(5): e247-346.

Dessertenne F. Ventricular tachycardia with two variable opposing foci. Arch Mal Coeur Vaiss 1966; 59: 263-272.

Leenhardt A, Glaser E, Burguera M, Nürnberg M, MaisonBlanche P, Coumel P. Short-coupled variant of torsade de pointes. A new electrocardiographic entity in the spectrum of idiopathic ventricular tachyarrhythmias. Circulation 1994; 89(1): 206-215. https://doi.org/10.1161/01.CIR.89.1.206

Ashida K, Kaji Y, Sasaki Y. Abolition of Torsade de Pointes after radiofrequency catheter ablation at right ventricular outflow tract. Int J Cardiol 1997; 59: 171-175. https://doi.org/10.1016/S0167-5273(97)02938-0

Kusano KF, Yamamoto M, Emori T, et al. Successful catheter ablation in a patient with polymorphic ventricular tachycardia. J Cardiovasc Electrophysiol 2000; 11: 682-685. https://doi.org/10.1111/j.1540-8167.2000.tb00031.x

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2019-03-25

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