Focal Purkinje ventricular tachycardia ablation in structurally normal heart
Jaishankar Krishnamoorthy1, Anitha Lakshmanan2, Ajit Mullasari2
1Department of Cardiology, Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, India drkjs68@yahoo.com.
Abstract:
A 21-year-old man presented with recurrent palpitations and giddiness. Clinical examination, echocardiography, and magnetic resonance imaging revealed a structurally normal heart. Electrocardiography showed broad-complex tachycardia with 250 beats per minute, which required cardioversion. An electrophysiological study could not induce tachycardia by programmed electrical stimulation. On isoprenaline infusion, frequent ventricular ectopics, bigeminy, nonsustained ventricular tachycardia, and broad-complex tachycardia similar to clinical tachycardia were readily inducible. This was considered to be ventricular tachycardia due to enhanced automaticity. Using 3-dimensional electroanatomical mapping, successful ablation was undertaken. The patient was asymptomatic on follow-up after 12 and 18 months.
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