HeartRhythm Case Reports

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HeartRhythm Case Reports Successful radiofrequency catheter ablation of a premature ventricular contraction triggering ventricular fibrillation in a patient with short QT syndrome Yoshimasa Morimoto, MD, Atsuyuki Watanabe, MD, PhD, Hiroshi Morita, MD, PhD, Nobuhiro Nishii, MD, PhD, Kazufumi Nakamura, MD, PhD, Hiroshi Ito, MD, PhD HeartRhythm Case Reports DOI: 10.1016/j.hrcr.2019.01.012 Copyright © 2019 Heart Rhythm Society Terms and Conditions

Figure 1 Electrocardiograms (ECGs) of the patient. A: Twelve-lead ECG immediately after resuscitation. The QT interval was remarkably short despite hypopotassemia (QTc 308 ms, K 2.8 mEq/L). B: Twelve-lead ECG 7 days after resuscitation: the potassium level was in the normal range (K 4.0 mEq/L), but the QT interval was still short (QTc 319 ms). HeartRhythm Case Reports DOI: (10.1016/j.hrcr.2019.01.012) Copyright © 2019 Heart Rhythm Society Terms and Conditions

Figure 2 The occurrence of premature ventricular contractions (PVCs) and polymorphic ventricular tachycardia. A: Twelve-lead electrocardiogram (ECG) showed that frequent occurrence of monofocal PVCs induced nonsustained polymorphic ventricular tachycardias with a short coupling interval (270 ms). B: Intracardiac ECG recorded by an implantable cardioverter-defibrillator at the onset of recurrent ventricular fibrillation episode. The coupling interval of the initial PVC was 273 ms. HeartRhythm Case Reports DOI: (10.1016/j.hrcr.2019.01.012) Copyright © 2019 Heart Rhythm Society Terms and Conditions

Figure 3 Radiofrequency catheter ablation for triggered premature ventricular contractions (PVCs). A prepotential of the PVC and a good match of the QRS configuration obtained by pace mapping at the inferolateral free wall of the right ventricle. Application of radiofrequency catheter ablation to that site and additional ablation around that site completely eliminated PVCs and ventricular tachycardias. ABL = ablation; CS = coronary sinus; LAO = left anterior oblique; RAO = right anterior oblique. HeartRhythm Case Reports DOI: (10.1016/j.hrcr.2019.01.012) Copyright © 2019 Heart Rhythm Society Terms and Conditions