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Ventricular fibrillation occurring after atrioventricular node ablation despite minimal difference between pre- and
F Squara1, G Theodore1, D Scarlatti1
1Cardiology department, Pasteur university hospital, Nice, France.
Ventricular fibrillation (VF) can occur after atrioventricular node (AVN) ablation even with minimal heart rate changes. This case highlights the need for temporary fast ventricular pacing after AVN ablation, regardless of baseline heart rate.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Atrioventricular node (AVN) ablation is a procedure to treat certain heart rhythm disorders.
- Ventricular fibrillation (VF) is a rare but serious complication following AVN ablation.
Purpose of the Study:
- To report a case of VF after AVN ablation in a patient with minimal heart rate drop.
- To emphasize the importance of temporary fast ventricular pacing after AVN ablation.
Main Methods:
- Case report of an 82-year-old man with valvular cardiomyopathy and chronic atrial fibrillation (AF).
- Patient underwent biventricular implantable cardiac defibrillator placement prior to AVN ablation.
- Analysis of heart rate changes and occurrence of VF post-ablation.
Main Results:
- VF occurred acutely after AVN ablation despite a slow pre-ablation heart rate (84 bpm) and a minimal heart rate drop (14 bpm).
- The VF was successfully treated with external electrical cardioversion.
- Previous reports linked VF post-ablation to significant heart rate drops (>30 bpm).
Conclusions:
- VF can occur after AVN ablation irrespective of the magnitude of heart rate drop.
- Temporary fast ventricular pacing is crucial after AVN ablation in all patients, regardless of pre-ablation heart rate.
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