Radiofrequency Catheter Ablations of Left Ventricular Arrhythmias Originating from Posteromedial Followed by Anterolateral Papillary Muscles

DOI HANDLE Web Site Open Access
  • Fujita Kazumasa
    Department of Medicine and Biosystemic Science, Kyushu University Hospital
  • Irie Kei
    Department of Medicine and Biosystemic Science, Kyushu University Hospital
  • Moriyama Shohei
    Department of Medicine and Biosystemic Science, Kyushu University Hospital
  • Yokoyama Taku
    Department of Medicine and Biosystemic Science, Kyushu University Hospital
  • Yasuda Shioto
    Department of Medicine and Biosystemic Science, Kyushu University Hospital
  • Fukata Mitsuhiro
    Department of Medicine and Biosystemic Science, Kyushu University Hospital
  • Arita Takeshi
    Department of Medicine and Biosystemic Science, Kyushu University Hospital
  • Odashiro Keita
    Department of Medicine and Biosystemic Science, Kyushu University Hospital
  • Maruyama Toru
    Faculty of Arts and Science, Kyushu University
  • Akashi Koichi
    Department of Medicine and Biosystemic Science, Kyushu University Hospital

Bibliographic Information

Other Title
  • 後内側乳頭筋ついで前外側乳頭筋に起源をもつ特発性心室期外収縮に対して高周波心筋焼灼術を施行した1例
  • Case Report : Radiofrequency Catheter Ablations of Left Ventricular Arrhythmias Originating from Posteromedial Followed by Anterolateral Papillary Muscles

Search this article

Abstract

A 61-year-old male presented fatigue, and ambulatory monitoring demonstrated frequent isolated premature ventricular beats (PVBs) with superior axis and right-bundle-branch-block (RBBB) configuration. Echocardiogram showed diffuse hypokinetic left ventricular (LV) wall motion and subnormal LV ejection fraction (LVEF). In electrophysiological study (EPS), pace map was optimal at the posteromedial papillary muscle (PM). Low-frequency mid-diastolic Purkinje potential (P1) preceded surface QRS complex of PVBs by 20 msec, and high-frequency Purkinje potential (P2) was observed immediately before QRS complex of sinus beats and PVBs. After successful radiofrequency ablation for PVBs arising from posteromedial PM, LVEF restored. However, one and half year later, PVBs showing inferior axis and RBBB appeared and LVEF declined. EPS and ablation were performed again and PVBs originating from anterolateral PM were eliminated. Considering that LV arrhythmia arising from PMs is refractory to ablation due to anatomical and technical reasons, careful follow-up is required.

Journal

  • 福岡醫學雜誌

    福岡醫學雜誌 108 (12), 244-252, 2017-12-25

    Fukuoka Medical Association

Keywords

Details 詳細情報について

Report a problem

Back to top