Skip to main content
SpringerLink
Log in

Catheter Ablation for Triggered Ventricular Fibrillation and Polymorphic Ventricular Tachycardia

  • Chapter
  • First Online:
Book cover Electrical Diseases of the Heart

  • 2112 Accesses

Abstract

Implantable Cardioverter Defibrillator (ICD) remains the first line therapy for patients with primary VF or polymorphic VT. However, catheter ablation of Ventricular Fibrillation (VF) is an important therapeutic option in patients with recurrent VF. These procedures mainly focus on targeting triggers. The role of Ventricular Premature Beat (VPB) initiating VF is crucial and their elimination shown to be effective to prevent recurrence in 82 % after 5 years in idiopathic VF. These VPBs, mainly (87 %) originate from the Purkinje network (right and/or left) and have some specific features. In addition, several experimental studies demonstrated that Purkinje fibers act as initiator and perpetuator of VF. Hence, by ablating an area where the triggering VPB are found to originate, catheter ablation may modify the local substrate too.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Aizawa Y, Tamura M, Chinushi M, et al. An attempt at electrical catheter ablation of the arrhythmogenic area in idiopathic ventricular fibrillation. Am Heart J. 1992;123:257–60.

    Article  PubMed  CAS  Google Scholar 

  2. Ashida K, Kaji Y, Sasaki Y. Abolition of Torsade de Pointes after radiofrequency catheter ablation at right ventricular outflow tract. Int J Cardiol. 1997;59:171–5.

    Article  PubMed  CAS  Google Scholar 

  3. Takatsuki S, Mitamura H, Ogawa S. Catheter ablation of a monofocal premature ventricular complex triggering idiopathic ventricular fibrillation. Heart. 2001;86:E3.

    Article  PubMed  CAS  Google Scholar 

  4. Haissaguerre M, Shah DC, Jais P, et al. Role of Purkinje conducting system in triggering of idiopathic ventricular fibrillation. Lancet. 2002;359:677–8.

    Article  PubMed  Google Scholar 

  5. Haissaguerre M, Shoda M, Jais P, et al. Mapping and ablation of idiopathic ventricular fibrillation. Circulation. 2002;106:962–7.

    Article  PubMed  Google Scholar 

  6. Paul T, Laohakunakorn P, Long B, Saul JP. Complete elimination of incessant polymorphic ventricular tachycardia in an infant with MIDAS syndrome: use of endocardial mapping and radiofrequency catheter ablation. J Cardiovasc Electrophysiol. 2002;13:612–15.

    Article  PubMed  Google Scholar 

  7. Haissaguerre M, Extramiana F, Hocini M, et al. Mapping and ablation of ventricular fibrillation associated with long-QT and Brugada syndromes. Circulation. 2003;108:925–8.

    Article  PubMed  Google Scholar 

  8. Bansch D, Oyang F, Antz M, et al. Successful catheter ablation of electrical storm after myocardial infarction. Circulation. 2003;108:3011–16.

    Article  PubMed  Google Scholar 

  9. Marrouche NF, Verma A, Wazni O, et al. Mode of initiation and ablation of ventricular fibrillation storms in patients with ischemic cardiomyopathy. J Am Coll Cardiol. 2004;43:1715–20.

    Article  PubMed  Google Scholar 

  10. Szumowski L, Sanders P, Walczak F, et al. Mapping and ablation of polymorphic ventricular tachycardia after myocardial infarction. J Am Coll Cardiol. 2004;44:1700–6.

    Article  PubMed  Google Scholar 

  11. Li YG, Gronefeld G, Israel C, Hohnloser SH. Catheter ablation of frequently recurring ventricular fibrillation in a patient after aortic valve repair. J Cardiovasc Electrophysiol. 2004;15:90–3.

    Article  PubMed  Google Scholar 

  12. Nademanee K, Veerakul G, Chandanamattha P, et al. Prevention of ventricular fibrillation episodes in Brugada syndrome by catheter ablation over the anterior right ventricular outflow tract epicardium. Circulation. 2011;123:1270–9.

    Article  PubMed  Google Scholar 

  13. Haissaguerre M, Sanders P, Hocini M, et al. Changes in atrial fibrillation cycle length and inducibility during catheter ablation and their relation to outcome. Circulation. 2004;109:3007–13.

    Article  PubMed  Google Scholar 

  14. Sasyniuk BI, Mendez C. A mechanism for reentry in canine ventricualar tissue. Circ Res. 1971;28:3–15.

    Article  PubMed  CAS  Google Scholar 

  15. Berenfeld O, Jalife J. Purkinje-muscle reentry as a mechanism of polymorphic ventricular arrhythmias in a 3-dimensional model of the ventricles. Circ Res. 1998;82:1063–77.

    Article  PubMed  CAS  Google Scholar 

  16. Pak HN, Kim YH, Lim HE, et al. Role of the posterior papillary muscle and purkinje potentials in the mechanism of ventricular fibrillation in open chest dogs and swine: effects of catheter ablation. J Cardiovasc Electrophysiol. 2006;17:777–83.

    Article  PubMed  Google Scholar 

  17. Tabereaux PB, Walcott GP, Rogers JM, et al. Activation patterns of Purkinje fibers during long-duration ventricular fibrillation in an isolated canine heart model. Circulation. 2007;116:1113–19.

    Article  PubMed  Google Scholar 

  18. Sacher F, Victor J, Hocini M, et al. Characterization of premature ventricular contraction initiating ventricular fibrillation. Arch Mal Coeur Vaiss. 2005;98:867–73.

    PubMed  CAS  Google Scholar 

  19. Nakagawa H, Beckman KJ, McClelland JH, et al. Radiofrequency catheter ablation of idiopathic left ventricular tachycardia guided by a Purkinje potential. Circulation. 1993;88:2607–17.

    Article  PubMed  CAS  Google Scholar 

  20. Knecht S, Sacher F, Wright M, et al. Long-term follow-up of idiopathic ventricular fibrillation ablation: a multicenter study. J Am Coll Cardiol. 2009;54:522–8.

    Article  PubMed  Google Scholar 

  21. Yan GX, Antzelevitch C. Cellular basis for the Brugada syndrome and other mechanisms of arrhythmogenesis associated with ST-segment elevation. Circulation. 1999;100:1660–6.

    Article  PubMed  CAS  Google Scholar 

  22. Coronel R, Casini S, Koopmann TT, et al. Right ventricular fibrosis and conduction delay in a patient with clinical signs of Brugada syndrome: a combined electrophysiological, genetic, histopathologic, and computational study. Circulation. 2005;112:2769–77.

    Article  PubMed  Google Scholar 

  23. Postema PG, van Dessel PF, de Bakker JM, et al. Slow and discontinuous conduction conspire in Brugada syndrome: a right ventricular mapping and stimulation study. Circ Arrhythm Electrophysiol. 2008;1:379–86.

    Article  PubMed  Google Scholar 

  24. Lambiase PD, Ahmed AK, Ciaccio EJ, et al. High-density substrate mapping in Brugada syndrome: combined role of conduction and repolarization heterogeneities in arrhythmogenesis. Circulation. 2009;120(106–17):1–4.

    Google Scholar 

  25. Kakishita M, Kurita T, Matsuo K, et al. Mode of onset of ventricular fibrillation in patients with Brugada syndrome detected by implantable cardioverter defibrillator therapy. J Am Coll Cardiol. 2000;36:1646–53.

    Article  PubMed  CAS  Google Scholar 

  26. Chinushi M, Washizuka T, Chinushi Y, Higuchi K, Toida T, Aizawa Y. Induction of ventricular fibrillation in Brugada syndrome by site-specific right ventricular premature depolarization. Pacing Clin Electrophysiol. 2002;25:1649–51.

    Article  PubMed  Google Scholar 

  27. Morita H, Fukushima-Kusano K, Nagase S, et al. Site-specific arrhythmogenesis in patients with Brugada syndrome. J Cardiovasc Electrophysiol. 2003;14:373–9.

    Article  PubMed  Google Scholar 

  28. Shah AJ, Hocini M, Lamaison D, Sacher F, Derval N, Haissaguerre M. Regional substrate ablation abolishes brugada syndrome. J Cardiovasc Electrophysiol. 2011;22(11):1290–1.

    Article  PubMed  Google Scholar 

  29. Sacher F, Roberts-Thomson K, Maury P, et al. Epicardial ventricular tachycardia ablation a multicenter safety study. J Am Coll Cardiol. 2010;55:2366–72.

    Article  PubMed  Google Scholar 

  30. Haissaguerre M, Sacher F, Nogami A, et al. Characteristics of recurrent ventricular fibrillation associated with inferolateral early repolarization role of drug therapy. J Am Coll Cardiol. 2009;53:612–19.

    Article  PubMed  Google Scholar 

  31. Plaster NM, Tawil R, Tristani-Firouzi M, et al. Mutations in Kir2.1 cause the developmental and episodic electrical phenotypes of Andersen’s syndrome. Cell. 2001;105:511–19.

    Article  PubMed  CAS  Google Scholar 

  32. Zhang L, Benson DW, Tristani-Firouzi M, et al. Electrocardiographic features in Andersen-Tawil syndrome patients with KCNJ2 mutations: characteristic T-U-wave patterns predict the KCNJ2 genotype. Circulation. 2005;111:2720–6.

    Article  PubMed  Google Scholar 

  33. Chun TU, Epstein MR, Dick 2nd M, et al. Polymorphic ventricular tachycardia and KCNJ2 mutations. Heart Rhythm. 2004;1:235–41.

    Article  PubMed  Google Scholar 

  34. Smith AH, Fish FA, Kannankeril PJ. Andersen-tawil syndrome. Indian Pacing Electrophysiol J. 2006;6:32–43.

    PubMed  Google Scholar 

  35. Friedman PL, Stewart JR, Fenoglio Jr JJ, Wit AL. Survival of subendocardial Purkinje fibers after extensive myocardial infarction in dogs. Circ Res. 1973;33:597–611.

    Article  PubMed  CAS  Google Scholar 

  36. Mlcochova H, Saliba WI, Burkhardt DJ, et al. Catheter ablation of ventricular fibrillation storm in patients with infiltrative amyloidosis of the heart. J Cardiovasc Electrophysiol. 2006;17:426–30.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Electrophysiology, CHU de Bordeaux, Hopital Cardiologique du Haut Leveque, Avenue de Magellan, 33604, Pessac CEDEX, France

    Frédéric Sacher MD, Mélèze Hocini MD, Sébastien Knecht MD, Nicolas Derval MD, Pierre Jaïs MD & Michel Haïssaguerre MD

  2. IHU LIRYC, INSERM 1045, Bordeaux University, Bordeaux, France

    Frédéric Sacher MD, Mélèze Hocini MD, Sébastien Knecht MD, Nicolas Derval MD, Pierre Jaïs MD & Michel Haïssaguerre MD

Authors
  1. Frédéric Sacher MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mélèze Hocini MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sébastien Knecht MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nicolas Derval MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pierre Jaïs MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michel Haïssaguerre MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Frédéric Sacher MD .

Editor information

Editors and Affiliations

  1. , Department of Internal Medicine, UMDNJ-RWJ Medical School, Robert Wood Johnson Pl. 1, New Brunswick, 08903-0019, New Jersey, USA

    Ihor Gussak

  2. , Gordon K. Moe Scholar, Masonic Medical Research Laboratory, Bleecker Street, Utica, 13501-1787, New York, USA

    Charles Antzelevitch

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Sacher, F., Hocini, M., Knecht, S., Derval, N., Jaïs, P., Haïssaguerre, M. (2013). Catheter Ablation for Triggered Ventricular Fibrillation and Polymorphic Ventricular Tachycardia. In: Gussak, I., Antzelevitch, C. (eds) Electrical Diseases of the Heart. Springer, London. https://doi.org/10.1007/978-1-4471-4978-1_37

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4978-1_37

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4977-4

  • Online ISBN: 978-1-4471-4978-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation