Catheter ablation of focus triggering ventricular fibrillation in patients with structural heart disease

Czech version

Authors: Josef Kautzner; Petr Peichl
Authors‘ workplace: Klinika kardiologie IKEM Praha, přednosta prof. MUDr. Josef Kautzner, CSc.
Published in: Vnitř Lék 2014; 60(12): 1055-1061
Category: 70. birthday prof. MUDr. Michael Aschermann, DrSc., FESC, FACC

Overview

First experiences with ablation of focus triggering ventricular fibrillation were reported in isolated cases of idiopathic ventricular fibrillation. Later, there were described the options in management of an electrical instability triggered by ectopic activity in patients after myocardial infarction. In both cases it was shown that the sources of extrasystoles originate almost exclusively from conducting system of chambers. Subsequently, isolated cases were also reported in other structural diseases. It is important that the urgent catheter ablation is able to remove focus which triggers electric instability. In many cases it is a lifesaving procedure. This review summarizes the current knowledge of the catheter ablation of focus triggering ventricular fibrillation with structural heart disease.

Key words:
catheter ablation – Purkinje fibres – ventricular fibrillation

Sources

1. Jalife J. Ventricular fibrillation: Mechanisms of initiation and maintenance. Annu Rev Physiol 2000; 62: 25–50.

2. Zaitsev AV, Berenfeld O, Mironov SF et al. Distribution of excitation frequencies on the epicardial and endocardial surfaces of fibrillating ventricular wall of the sheep heart. Circ Res 2000; 86(4): 408–417.

3. Chen J, Mandapati R, Berenfeld O et al. High-frequency periodic sources underlie ventricular fibrillation in the isolated rabbit heart. Circ Res 2000; 86(1): 86–93.

4. Newton JC, Smith WM, Ideker RE. Estimated global transmural distribution of activation rate and conduction block during porcine and canine ventricular fibrillation. Circ Res 2004; 94(6): 836–842.

5. Nanthakumar K, Huang J, Rogers JM et al. Regional differences in ventricular fibrillation in the open-chest porcine left ventricle. Circ Res 2002; 91(8): 733–740.

6. Huang J, Walcott GP, Killingsworth CR et al. Quantification of activation patterns during ventricular fibrillation in open-chest porcine left ventricle and septum. Heart Rhythm 2005; 2(7): 720–728.

7. 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(7): 777–783.

8. Pak HN, Oh YS, Liu YB et al. Catheter ablation of ventricular fibrillation in rabbit ventricles treated with beta-blockers. Circulation 2003; 108(25): 3149–3156.

9. Pak HN, Kim GI, Lim HE et al. Both Purkinje cells and left ventricular posteroseptal reentry contribute to the maintenance of ventricular fibrillation in open-chest dogs and swine: effects of catheter ablation and the ventricular cut-and-sew operation. Circ J 2008; 72(7): 1185–1119.

10. Haïssaguerre M, Shah DC, Jaïs P et al. Role of Purkinje conducting system in triggering of idiopathic ventricular fibrillation. Lancet 2002; 359(9307): 677–678.

11. Haïssaguerre M, Shoda M, Jaïs P et al. Mapping and ablation of idiopathic ventricular fibrillation. Circulation 2002; 106(8): 962–967.

12. Bänsch D, Oyang F, Antz M et al. Successful catheter ablation of electrical storm after myocardial infarction. Circulation 2003; 108(24): 3011–3016.

13. Nash MP, Mourad A, Clayton RH et al. Evidence for multiple mechanisms in human ventricular fibrillation. Circulation 2006; 114(6): 536–542.

14. Kautzner J, Bytešník J. Catheter ablation of arrhythmogenic focus in “short-coupled” variant of Torsade de Pointes. Pacing Clin Electrophysiol 2000; 23(Pt 2): 717.

15. 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(6): 522–528.

16. Enjoji Y, Mizobuchi M, Muranishi H et al. Catheter ablation of fatal ventricular tachyarrhythmias storm in acute coronary syndrome – role of Purkinje fiber network. J Interv Card Electrophysiol 2009; 26(3): 207–215.

17. 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(9): 1715–1720.

18. Szumowski L, Sanders P, Walczak F et al. Mapping and ablation of polymorphic ventricular tachycardia after myocardial infarction. J Am Coll Cardiol 2004; 44(8): 1700–1706.

19. Peichl P, Cihák R, Kozeluhová M et al. Catheter ablation of arrhythmic storm triggered by monomorphic ectopic beats in patients with coronary artery disease. J Interv Card Electrophysiol 2010; 27(1): 51–59.

20. Friedman PL, Stewart JR, Fenoglio JJ Jr et al. Survival of subendocardial Purkinje fibers after extensive myocardial infarction in dogs: in vitro and in vivo correlations. Circ Res 1973; 33(5): 597–611.

21. Myers WW, Honic CR. Amount and distribution of Rb transported into myocardium from ventricular lumen. Am J Physiol 1966; 211(3): 739–745.

22. Moir TW. Study of luminal coronary collateral circulation in the beating canine heart. Circ Res 1969; 24(5): 735–744.

23. Bagdonas AA, Stuckey JH, Piera J et al. Effects of ischemia and hypoxia on the specialized conduction system of the canine heart. Am Heart J 1961; 61: 206–218.

24. Arnar DO, Bullinga JR, Martins JB. Role of the Purkinje system in spontaneous ventricular tachycardia during acute ischemia in a canine model. Circulation 1997; 96(7): 2421–2429.

25. Berenfeld O, Jalife J. Purkinje-muscle reentry as a mechanism of polymorphic ventricular arrhythmias in a three-dimensional model of the ventricles. Circ Res 1998; 82(10): 1063–1077.

26. Kupersmith J, Li ZY, Maidonado C. Marked action potential prolongation as a source of injury current leading to border zone arrhythmogenesis. Am Heart J 1994; 127(6): 1543–1553.

27. Nogami A, Kubota S, Adachi M et al. Electrophysiologic and histopathologic findings of the ablation sites for ventricular fibrillation in a patient with ischemic cardiomyopathy. J Interv Card Electrophysiol 2009; 24(2): 133–137.

28. Sinha AM, Schmidt M, Marschang H et al. Role of left ventricular scar and Purkinje-like potentials during mapping and ablation of ventricular fibrillation in dilated cardiomyopathy. Pacing Clin Electrophysiol 2009; 32(3): 286–290.

29. Kirubakaran S, Gill J, Rinaldi CA. Successful catheter ablation of focal ventricular fibrillation in a patient with nonischemic dilated cardiomyopathy. Pacing Clin Electrophysiol 2011; 34(4): e38-e42. Dostupné z DOI: <http://DOI: 10.1111/j.1540–8159.2010.02750.x>.

30. Li YG, Gronefeld G, Israel C et al. Catheter ablation of frequently recurring ventricular fibrillation in a patient after aortic valve repair. J Cardiovasc Electrophysiol 2004; 15(1): 90–93.

31. Bode K, Hindricks G, Piorkowski C et al. Ablation of polymorphic ventricular tachycardias in patients with structural heart disease. Pacing Clin Electrophysiol 2008; 31(12): 1585–1591.

32. 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(4): 426–430.