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Successful focal ablation in a patient with electrical storm in the early postinfarction period: case report

Authors Aksu T, Guler T, Golcuk E, Ozcan K, Erden I

Received 16 December 2014

Accepted for publication 30 January 2015

Published 27 February 2015 Volume 2015:8 Pages 59—63


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Ronald Prineas

Supplementary video presented by Tolga Aksu

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Tolga Aksu,1 Tumer Erdem Guler,1 Ebru Golcuk,2 Kazim Serhan Ozcan,1 Ismail Erden1

1Department of Cardiology, Derince Training and Research Hospital, Kocaeli, Turkey; 2Department of Cardiology, School of Medicine, Koç University, Istanbul, Turkey

Abstract: Electrical storm (ES) is associated with a poor prognosis if it occurs in the early postinfarction period (within 4 weeks). There are limited data on the efficacy and safety of catheter ablation in the early period. In the patients with postinfarction cardiomyopathy, ventricular tachycardia (VT) is usually caused by re-entry through slowly conducting tissue within areas of a myocardial scar, whereas for the early postinfarction period, the underlying mechanism of ES is not fully understood. We report a case of ES for which macroreentry was excluded as a mechanism of VT because of the clinical and electrophysiological properties of the tachycardia. The tachycardia was terminated by focal radiofrequency catheter ablation of the earliest site. The total procedure time was only 35 minutes. During a 12-month follow-up period, the patient has remained free of monomorphic VT episodes. On the basis of this case, we aimed to discuss the underlying mechanism of ES in the early postinfarction period and to evaluate the role of radiofrequency catheter ablation as a primary approach for treating ES.

Keywords: ablation, electrical storm, ventricular tachycardia

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