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Ventricular tachycardia with congenital ventricular diverticulum
E N Shen1, O Fukuyama, J M Herre
1Department of Medicine, University of Hawaii, Straub Clinic, Honolulu.
Chest
|July 1, 1991
Summary
A young man with recurrent ventricular tachycardia (VT) due to a left ventricular diverticulum underwent surgery. Surgical intervention and procainamide controlled his VT, significantly improving his prognosis.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Surgery
Background:
- Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia.
- Left ventricular diverticulum is a rare congenital anomaly that can be associated with arrhythmias.
- Management of drug-refractory VT can be challenging.
Observation:
- A 24-year-old male presented with symptomatic, recurrent, sustained ventricular tachycardia.
- The patient was diagnosed with a basal inferior left ventricular diverticulum.
- VT was reproducible on electrophysiological study and unresponsive to multiple antiarrhythmic drugs.
Findings:
- Endocardial mapping, resection, and cryoablation were performed for VT ablation.
- The patient experienced only one recurrence of VT 18 months post-surgery.
- Subsequent VT episodes were controlled with procainamide for over 14 months.
Implications:
- Surgical intervention including resection and cryoablation can be effective for VT associated with left ventricular diverticulum.
- Left ventricular diverticulum should be considered in the differential diagnosis of young patients with recurrent VT.
- A multimodal approach combining surgery and pharmacotherapy may offer long-term VT control.