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Kim H. Chan, MBBS, PhD, Raymond W. Sy, MBBS, PhD 

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Presentation on theme: "Kim H. Chan, MBBS, PhD, Raymond W. Sy, MBBS, PhD "— Presentation transcript:

1 Catheter Ablation of Recurrent Ventricular Fibrillation: A Literature Review and Case Examples 
Kim H. Chan, MBBS, PhD, Raymond W. Sy, MBBS, PhD  Heart, Lung and Circulation  Volume 25, Issue 8, Pages (August 2016) DOI: /j.hlc Copyright © Terms and Conditions

2 Figure 1 (A) Example of polymorphic VT on 12-lead ECG; (B) Polymorphic VT initiated by fascicular PVC in posterior septum of left ventricle (LV); Fascicular potentials preceding the initial PVC and during VT (arrows) (C) Left anterior oblique fluoroscopic view showing catheter positions (RA = right atrial, HBE = his bundle catheter, RV = right ventricular catheter, CS = coronary sinus). Heart, Lung and Circulation  , DOI: ( /j.hlc ) Copyright © Terms and Conditions

3 Figure 2 Monomorphic PVCs arising from the RVOT triggering (A) non-sustained VT; (B) initiation of VF; (C) Activation map showing earliest activation from the superior free wall of the RVOT (right anterior oblique view; ablation lesions are shown in red). Heart, Lung and Circulation  , DOI: ( /j.hlc ) Copyright © Terms and Conditions

4 Figure 3 (A) Frequent monomorphic PVCs (arrow) triggering non-sustained VT; (B) PVC with the same morphology (arrow) triggering sustained VT; (C) Endocardial voltage map of LV. Yellow dots represent sites of good pace-map. Red dots represent ablation sites. The sites of good pace-map corresponded with the infarct border zone along the mid LV septum. (RAO = right anterior oblique view); (D) I. Frequent monomorphic PVC (arrow) during electrophysiology study, II. Purkinje potentials (arrow) during atrial pacing, III. Pace-map at same site (dABL = distal electrode pair of ablation catheter; pABL = proximal electrode pair of ablation catheter). Heart, Lung and Circulation  , DOI: ( /j.hlc ) Copyright © Terms and Conditions

5 Figure 4 Both right bundle superior and inferior axis PVCs (arrows) initiate VT. Heart, Lung and Circulation  , DOI: ( /j.hlc ) Copyright © Terms and Conditions

6 Figure 5 Ablation of superior axis PVC. (A) Ablation lesions along the posteroseptal LV (anteroposterior view); (B) Superior axis PVC (arrows) initiates sustained VT; (C) pre-systolic potentials (arrow) were seen at site of ablation; (D) Automaticity during ablation. Heart, Lung and Circulation  , DOI: ( /j.hlc ) Copyright © Terms and Conditions

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