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Successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation

Ventricular tachycardia (VT) may cause sudden death late after repair of congenital heart disease. Radiofrequency catheter ablation (CA) of VT can be effective but may be hampered by hypertrophied myocardium or prosthetic material. A 33-year-old man with congenitally corrected transposition of the g...

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Autores principales: Toyohara, Keiko, Nishimura, Tomomi, Nakanishi, Toshio, Shoda, Morio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792815/
https://www.ncbi.nlm.nih.gov/pubmed/27066360
http://dx.doi.org/10.1186/s40064-016-1903-4
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author Toyohara, Keiko
Nishimura, Tomomi
Nakanishi, Toshio
Shoda, Morio
author_facet Toyohara, Keiko
Nishimura, Tomomi
Nakanishi, Toshio
Shoda, Morio
author_sort Toyohara, Keiko
collection PubMed
description Ventricular tachycardia (VT) may cause sudden death late after repair of congenital heart disease. Radiofrequency catheter ablation (CA) of VT can be effective but may be hampered by hypertrophied myocardium or prosthetic material. A 33-year-old man with congenitally corrected transposition of the great arteries (ccTGA) had undergone a double switch operation (DSO) with the combined Mustard and Rastelli procedures when he was 10 years old. He developed sustained VT 16 years after the surgery. An electrophysiological study was performed using a 3D mapping system. During the VT, abnormal fragmented potentials were identified in the right ventricular side near the patch of ventricular septal defect. Radiofrequency energy was delivered at the site with changes in the QRS morphology. Electroanatomical mapping of the left ventricle was performed via a retrograde transaortic approach. Successful ablation of the fractionated potentials was likewise achieved on the left side. We report, to our knowledge, the first case of a successful radiofrequency CA of VT in a patient with ccTGA after a DSO. A slow conduction zone, which was proved to be part of the tachycardia substrate, existed around the patch of ventricular septal defect. Fragmented activities during VT were recorded from both ventricles. The tachycardia circuit was eliminated after ablating the right and left sides of the ventricular septal defect patch.
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spelling pubmed-47928152016-04-09 Successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation Toyohara, Keiko Nishimura, Tomomi Nakanishi, Toshio Shoda, Morio Springerplus Case Study Ventricular tachycardia (VT) may cause sudden death late after repair of congenital heart disease. Radiofrequency catheter ablation (CA) of VT can be effective but may be hampered by hypertrophied myocardium or prosthetic material. A 33-year-old man with congenitally corrected transposition of the great arteries (ccTGA) had undergone a double switch operation (DSO) with the combined Mustard and Rastelli procedures when he was 10 years old. He developed sustained VT 16 years after the surgery. An electrophysiological study was performed using a 3D mapping system. During the VT, abnormal fragmented potentials were identified in the right ventricular side near the patch of ventricular septal defect. Radiofrequency energy was delivered at the site with changes in the QRS morphology. Electroanatomical mapping of the left ventricle was performed via a retrograde transaortic approach. Successful ablation of the fractionated potentials was likewise achieved on the left side. We report, to our knowledge, the first case of a successful radiofrequency CA of VT in a patient with ccTGA after a DSO. A slow conduction zone, which was proved to be part of the tachycardia substrate, existed around the patch of ventricular septal defect. Fragmented activities during VT were recorded from both ventricles. The tachycardia circuit was eliminated after ablating the right and left sides of the ventricular septal defect patch. Springer International Publishing 2016-03-16 /pmc/articles/PMC4792815/ /pubmed/27066360 http://dx.doi.org/10.1186/s40064-016-1903-4 Text en © Toyohara et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Study
Toyohara, Keiko
Nishimura, Tomomi
Nakanishi, Toshio
Shoda, Morio
Successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation
title Successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation
title_full Successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation
title_fullStr Successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation
title_full_unstemmed Successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation
title_short Successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation
title_sort successful catheter ablation of ventricular tachycardia in a patient with congenitally corrected transposition of great arteries after double switch operation
topic Case Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792815/
https://www.ncbi.nlm.nih.gov/pubmed/27066360
http://dx.doi.org/10.1186/s40064-016-1903-4
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