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Noncoronary ST elevation and polymorphic ventricular tachycardia during left-sided accessory pathway ablation.

Authors
Hwang, GS; Park, JS; Yang, HM; Lim, HS; Choi, BJ; Choi, SY; Yoon, MH; Shin, JH; Tahk, SJ
Citation
Journal of cardiovascular electrophysiology, 24(11):1240-1245, 2013
Journal Title
Journal of cardiovascular electrophysiology
ISSN
1045-38731540-8167
Abstract
INTRODUCTION: An early repolarization (ER) pattern on electrocardiogram (ECG) sometimes has the risk of polymorphic ventricular tachycardia (PVT) or ventricular fibrillation (VF). An abnormal ER pattern can develop in various experimental or clinical situations. We experienced 4 cases of abnormal ER pattern with or without PVT during the radiofrequency (RF) ablation of the left accessory pathway.



METHODS AND RESULTS: An electrophysiologic study and RF ablation were performed in 4 patients. Four patients had atrioventricular reentrant tachycardia. During RF ablation of the left accessory pathway, severe chest pain developed and was followed by abnormal J-point elevation. During the ongoing chest pain and J-point elevation, coronary angiograms showed normal findings. The chest pain and J-point elevation were followed by PVT or VF that was unresponsive to defibrillation. The PVT was spontaneously terminated and repeated. After 0.5 mg atropin was given, chest pain and ECG change disappeared.



CONCLUSION: The mechanisms of ER syndrome during RF ablation might be increased vagal tone due to chest pain or direct vagal stimulation.
Keywords
catheter ablation early repolarization syndromepolymorphic ventricular tachycardiavagal nerve stimulation
DOI
10.1111/jce.12217
PMID
23889813
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
황, 교승박, 진선양, 형모임, 홍석최, 병주최, 소연윤, 명호신, 준한탁, 승제
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