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Renal Sympathetic Denervation as an Adjunct to Catheter Ablation for the Treatment of Ventricular Electrical Storm in the Setting of Acute Myocardial Infarction
Author(s) -
HOFFMANN BORIS A.,
STEVEN DANIEL,
WILLEMS STEPHAN,
SYDOW KARSTEN
Publication year - 2013
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12207
Subject(s) - medicine , cardiology , ventricular fibrillation , myocardial infarction , ventricular tachycardia , percutaneous coronary intervention , left ventricular thrombus , catheter ablation , anesthesia , ablation
Renal Denervation in Ischemic Ventricular Storm We present a case of ventricular storm (VS) in a patient with acute ST‐elevation myocardial infarction (STEMI). After initial successful thrombus extraction and percutaneous coronary intervention (PCI) of the proximal left anterior descending (LAD) coronary artery, a 63‐year‐old male patient showed recurrent monomorphic ventricular tachycardia (VT) and fibrillation (VF) episodes refractory to antiarrhythmic drug therapy. After initial successful VT ablation, fast VT and VF episodes remained an evident problem despite maximum antiarrhythmic drug therapy. Due to an increasing instability, renal sympathetic denervation (RDN) was performed. ICD interrogation and 24‐hour Holter monitoring excluded recurrent episodes of VT or VF at a 6‐month follow‐up (FU) after discharge. This case highlights that RDN was effective and safely performed in a hemodynamically unstable patient with VS after STEMI and adjunct catheter ablation. RDN may open a new avenue for an adjunctive interventional bailout treatment of such highly challenging patients.