Premium
Noncoronary ST Elevation and Polymorphic Ventricular Tachycardia During Left‐Sided Accessory Pathway Ablation
Author(s) -
HWANG GYOSEUNG,
PARK JINSUN,
YANG HYOUNGMO,
LIM HONGSEOK,
CHOI BYOUNGJOO,
CHOI SOYEON,
YOON MYEONGHO,
SHIN JOONHAN,
TAHK SEUNGJEA
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.12217
Subject(s) - medicine , cardiology , chest pain , tachycardia , ventricular fibrillation , ablation , st elevation , benign early repolarization , accessory pathway , electrocardiography , radiofrequency ablation , catheter ablation , anesthesia , st segment , myocardial infarction
Noncoronary ST Elevation During Ablation Therapy Introduction An early repolarization (ER) pattern on electrocardiogram (ECG) sometimes has the risk of polymorphic ventricular tachycardia (PVT) or ventricular fibrillation (VF). An abnormal ER pattern can develop in various experimental or clinical situations. We experienced 4 cases of abnormal ER pattern with or without PVT during the radiofrequency (RF) ablation of the left accessory pathway. Methods and Results An electrophysiologic study and RF ablation were performed in 4 patients. Four patients had atrioventricular reentrant tachycardia. During RF ablation of the left accessory pathway, severe chest pain developed and was followed by abnormal J‐point elevation. During the ongoing chest pain and J‐point elevation, coronary angiograms showed normal findings. The chest pain and J‐point elevation were followed by PVT or VF that was unresponsive to defibrillation. The PVT was spontaneously terminated and repeated. After 0.5 mg atropin was given, chest pain and ECG change disappeared. Conclusion The mechanisms of ER syndrome during RF ablation might be increased vagal tone due to chest pain or direct vagal stimulation.