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Europace Advance Access originally published online on April 24, 2009
Europace 2009 11(8):1115-1117; doi:10.1093/europace/eup092
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

SHORT COMMUNICATIONS

Ventricular fibrillation induced by a radiofrequency energy delivery for idiopathic premature ventricular contractions arising from the left ventricular anterior papillary muscle

Takumi Yamada*, H. Thomas McElderry, James D. Allred, Harish Doppalapudi and G. Neal Kay

Division of Cardiovascular Disease, University of Alabama at Birmingham, VH B147, 1670 University Boulevard, 1530 3rd AVE S, Birmingham, AL 35294-0019, USA

A 73-year-old man with idiopathic premature ventricular contractions (PVCs) underwent electrophysiological testing. Left ventricular activation mapping revealed a focal mechanism of the PVCs with the earliest activation on the anterior papillary muscle (APM). Irrigated radiofrequency (RF) current delivered at that site induced a cluster of non-sustained ventricular tachycardia episodes with the same QRS morphology as the PVCs, followed by ventricular fibrillation (VF). The APM might have served as an abnormal automatic trigger and driver for the VF occurrence. Ventricular fibrillation may occur as a complication during RF catheter ablation of papillary muscle ventricular arrhythmias even if the clinical arrhythmia is limited to PVCs.

* Corresponding author. Tel: +1 205 975 4724, Fax: +1 205 975 4720, Email: takumi-y{at}fb4.so-net.ne.jp

Manuscript submitted 8 January 2009. Accepted after revision 2 March 2009.


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