Bail-out alcohol septal ablation in the management of obstructive hypertrophic cardiomyopathy and refractory electrical storm. Case resolution

Autor: Piero Custodio-Sánchez, Eduardo A. Arias, Santiago Nava-Townsend, Marco Antonio Peña-Duque, Hugo Rodríguez-Zanella, and Gabriela Meléndez-Ramírez
Rok vydání: 2021
Předmět:
Zdroj: REC: Interventional Cardiology (English Ed.), Vol 2, Iss 3, Pp 222-223 (2020)
ISSN: 2604-7322
DOI: 10.24875/recice.m19000072
Popis: CASE RESOLUTION The outcome was successful with a final 19-mmHg intraventricular gradient and after the extrasystole of 25 mmHg (figure 1). No more new events of ventricular tachycardia (VT) were reported, disease progression was good, and the patient remained asymptomatic at 3 months. Figure 1. A: gradient between left ventricle and initial aorta. B: gradient between left ventricle and final aorta. Sustained monomorphic VT in hypertrophic cardiomyopathy is a rare entity. These patients are considered eligible to receive an automated implantable-cardioverter defibrillator and antiarrhythmic drugs. Also, in cases of VT of focal origin, the mapping of cardiac electrophysiology and ablation is indicated. In 1989, Brugada et al.1 first published that in the management of patients in whom other options have failed, alcohol ablation of the coronary branches that irrigate the origin or route of VT is a valid therapeutic option to treat persistent tachycardia. Our case is unique because it describes the role of septal ablation for arrhythmic and hemodynamic control purposes in a septal region where the maximum gradient and origin of VT were located. Even though septal ablation can be less effective in large scars and hypertrophies ≥ 30 mm, it can also be a successful procedure and replace myectomy in high...
Databáze: OpenAIRE