Authors

• Ivica Benko — University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia — ORCID: 0000-0002-1878-0880
• Šime Manola — University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia — ORCID: 0000-0001-6444-2674
• Tomislav Krčmar — University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia — ORCID: 0000-0003-4689-1673
• Nikola Pavlović — University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia — ORCID: 0000-0001-9187-7681
• Ivan Zeljković — University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia — ORCID: 0000-0002-4550-4056
• Vjekoslav Radeljić — University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia — ORCID: 0000-0003-2471-4035
• Gordana Hursa — University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia — ORCID: 0000-0001-9118-9707
• Sanja Keleković — University Hospital Center “Sestre milosrdnice”, Zagreb, Croatia — ORCID: 0000-0003-4951-876X

Keywords

ablation, ventricular tachycardia, ST-segment elevation

DOI

Full Text

Nowadays, ablation treatment of ventricular tachycardia is more and more common, whether it is on structural-diseased or normal heart. (1) We report the case of a 47-year old female patient in whom an electrophysiology study (EP) with 3D mapping system (CARTO) was performed due to paroxysmal idiopathic sustained ventricular tachycardia (VT). Anterograde as well as retrograde approach was used during the procedure and fascicular VT using left posterior fascicle was diagnosed, however it was rather non-sustained. After 90 minutes of mapping, patient complained of chest pain and sustained VT was recorded in 12-lead electrocardiogram. After short conversion to sinus rhythm an ST-segment elevation in anterior leads was noticed. The EP procedure was aborted and coronary angiography was performed. Coronary angiography showed dissection of ostial left anterior descending artery and percutaneous coronary intervention with implantation of 2 drug-eluting stents was performed. After 3 months follow up, echocardiography showed normal left ventricular systolic function (EF 60%) with mild hypokinesia of the anteroseptal region. With verapamil as antiarrhythmic therapy the patient was free of VT during 6 months and without heart failure symptoms.

Literature

1. Lerman BB, Stein KM, Markowitz SM. Mechanisms of idiopathic left ventricular tachycardia. J Cardiovasc Electrophysiol. 1997;8(5):571–83. https://doi.org/10.1111/j.1540-8167.1997.tb00826.x