Successful Transvenous Radiofrequency Catheter Ablation of

Successful Transvenous Radiofrequency Catheter Ablation of

Successful Transvenous Radiofrequency Catheter Ablation of Ventricular Tachycardia In
Arrhythmogenic Right Ventricular Cardiomyopathy Without Antiarrhytmic Drugs and
Automated Intracardiac Defibrillator
Aritmojenik Sağ Ventrikül Kardiyomiyopatisinde Ventrikül Taşikardisinin Antiaritmik İlaç ve Otomatik
İntrakardiyak Defibrilatör Olmaksızın Transvenöz Radyofrekans Katater ile Başarılı Ablasyonu
Prof. Dr. Mustafa Yıldız
İstanbul Üniversitesi Kardiyoloji Enstitüsü, Kardiyoloji Kliniği, İstanbul, Türkiye
A 47-year-old woman was admitted to our hospital in sustained ventricular tachycardia with
hemodynamic collapse. The tachycardia terminated by electrical cardioversion. Her clinical
examination and resting electrocardiogram were unremarkable. Echocardiography and magnetic
resonance imaging showed arrhythmogenic right ventricular cardiomyopathy (ARVC) with normal left
ventricular function, with an ejection fraction of 62%. Her coronary angiography was normal. Taking all
factors into consideration, treatment by transvenous radiofrequency catheter ablation was planed.
Frequently ventricular extrasystole originated from right ventricular outflow tract were seen during the
electrophysiologic study. During ventricular tachycardia, catheter ablation was performed at right
ventricular outflow tract (Figure 1A, B). After seven seconds, radiofrequency current at a power of 50
0
W, 60 C terminated ventricular tachycardia (Figure 1C). Ablation was continued for another 40
seconds. Thirty minutes after radiofrequency ablation, no ventricular extrasystole or tachycardia could
be induced. Two years after procedure, the patient is free from recurrence without antiarrhytmic drugs
and automated intracardiac defibrillator. ARVC is a progressive fibro-fatty infiltrative myocardial
disease. It causes an electrical instability which may lead to ventricular tachycardia and sudden death
(1). The treatment includes antiarrhythmic drugs such as beta blockers, electrophysiological study with
ablation, and automated intracardiac defibrillator. Radiofrequency ablation may be effective for the
treatment of ventricular tachycardia with ARVC without antiarrhytmic drugs and automated intracardiac
defibrillator.
Reference
1. James
CA,
Calkins
H.
Update
on arrhythmogenic
right
ventricular
dysplasia/cardiomyopathy (ARVD/C). Curr Treat Options Cardiovasc Med 2013;15(4):476-87.
Figure 1A, B: During ventricular tachycardia, catheter ablation was performed. Figure 1C: After
seven seconds, the ventricular tachycardia was terminated. RF: Radiofrequency.