A 3-Dimensional Ablation At Patient With Tachycardia Right Ventricular Outflow Track (RVOT) Origin: First Experienced in Saiful Anwar General Hospital Malang
DOI:
https://doi.org/10.11594/jk-risk.03.3.9Keywords:
Three-Dimensional Ablation, frequent premature ventricular complexes, cardiomyopathy induced tachycardia, quality of lifeAbstract
Background: Premature ventricular complexes (PVCs) occur commonly in general population. It can occur in patient without structural heart disease as well as those with any form of cardiac disease. Commonly PVCs are asymptomatic, but in patients with frequent PVCs causing palpitations, syncope or dizziness, easily to fatigue, or shortness of breath. PVCs has been connected with a more than two-fold higher risk of cardiovascular events including stroke, mortality and also associated with arrhythmias or cardiomyopathy. Medications can be used to suppress PVCs but when drug therapy is ineffective, PVC ablation is reasonable to eliminate symptoms and treat or prevent PVC-induced cardiomyopathy.
Case Presentation: A hypertension and menopause, 57-year-old woman, frequently complained about palpitation with shortness of breath, dizziness and sometimes near syncope since 2017, occurring both at rest and with mild activities. After serial examinations, found Frequent PVC (39%) with RVOT-Origin and reduced ejection fraction (EF 48%), then conclude with Suspect Tachycardia Induced cardiomyopathies. She performs cardiac electrophysiological study and continue with 3-Dimentional Ablation with Radiofrequency (RFA) at RVOT in Saiful Anwar Hospital, that is The First 3-Dimension Ablation in East Java. 1 year follow up shows no recurrency and successful to improve quality of life of the patient
Discussion: According to guideline, catheter ablation is class I recommendation for patients with symptomatic outflow tract ventricular arrhythmias if medications are ineffective, not tolerated, or patient’s choose
Conclusion: Three-Dimensional Ablation at patient with Right Ventricular Outflow Track Tachycardia, can successfully eliminate PVCs with no recurrency in 1 year follow-up.
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References
Issa ZF, Miller JM, Zipes DP. Idiopathic Focal Ven-tricular Tachycardia. Clinical Arrhythmology and Electrophysiology. 2019;816–57.
Chung E, Young S, Chen MA. A case of premature ventricular contractions-related cardiomyopathy. J R Coll Physicians Edinb [Internet]. 2021 [cited 2023 Dec 11];51(3):262–5. Available from: https://pubmed.ncbi.nlm.nih.gov/34528615/
Can Yontar O, Yanik A, Erdogan G, Arslan U. Go-khan Aksan, Catheter ablation of para-hisian premature ventricular contractions using electro-anatomical mapping: Approaches and pitfalls Case Report CARDIOLOGY. North Clin Istanb [Internet]. 2022 [cited 2023 Dec 11];9(3):286–9. Available from: www.northclinist.com
Heeger CH, Hayashi K, Kuck KH, Ouyang F. Cathe-ter Ablation of Idiopathic Ventricular Arrhythmias Arising From the Cardiac Outflow Tracts – Recent Insights and Techniques for the Successful Treatment of Common and Challenging Cases –. Circulation Journal. 2016;80(5):CJ-16-0293.
Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, et al. 2017 AHA/ACC/HRS Guideline for Management of Pa-tients With Ventricular Arrhythmias and the Pre-vention of Sudden Cardiac Death. Circulation [In-ternet]. 2018 Sep 25 [cited 2023 Dec 11];138(13):e272–391. Available from: https://www.ahajournals.org/doi/abs/10.1161/CIR.0000000000000549
Huizar JF, Ellenbogen KA, Tan AY, Kaszala K. Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review. J Am Coll Cardiol [Internet]. 2019 May 14 [cited 2023 Dec 14];73(18):2328–44. Available from: https://www.jacc.org/doi/10.1016/j.jacc.2019.02.045
Tsiachris D, Botis M, Doundoulakis I, Bartsioka LI, Tsioufis P, Kordalis A, et al. Electrocardiographic Characteristics, Identification, and Management of Frequent Premature Ventricular Contractions. Diagnostics 2023, Vol 13, Page 3094 [Internet]. 2023 Sep 29 [cited 2023 Dec 14];13(19):3094. Available from: https://www.mdpi.com/2075-4418/13/19/3094/htm
Calvo N, Jongbloed M, Zeppenfeld K. Radiofre-quency Catheter Ablation of Idiopathic Right Ven-tricular Outflow Tract Arrhythmias. Indian Pacing Electrophysiol J [Internet]. 2013 [cited 2023 Dec 14];13(1):14. Available from: /pmc/articles/PMC3540113/
Erkapic D, Neumann T. Ablation of premature ventricular complexes exclusively guided by three-dimensional noninvasive mapping. Card Electrophysiol Clin [Internet]. 2015 Mar 1 [cited 2023 Dec 11];7(1):109–15. Available from: http://www.cardiacep.theclinics.com/article/S1877918214001488/fulltext
Maury P, Monteil B, Marty L, Duparc A, Mondoly P, Rollin A. Three-dimensional mapping in the electrophysiological laboratory. Arch Cardiovasc Dis. 2018 Jun 1;111(6–7):456–64.
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