Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Unusual Polymorphic Ventricular Tachycardia Originating from the Pulmonary Artery

  • Lee, Dae In (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Park, Sang Weon (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Kook, Hyungdon (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Woohyeun (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Dong Hyeok (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Lee, Sunki (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Oh, Suk-Kyu (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Kim, Young-Hoon (Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine)
  • Published : 2013.02.28
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Abstract

We report a case about a 27-year-old healthy young male who developed syncope during exercise, which was subsequently identified to be attributable to non-sustained polymorphic ventricular tachycardia (VT). Occurrence of polymorphic VT was neither related to a prolonged QT interval nor a fixed short coupling interval. Standard examinations including echocardiography, coronary angiography, isoproterenol infusion study, and cardiac MRI showed no structural heart disease. On the electrophysiology study, activation mapping revealed that a discrete potential preceded the premature ventricular complex (PVC) triggered polymorphic VT, which was recorded just above the pulmonary valve. After radiofrequency ablation at this area, PVC and polymorphic VT disappeared and did not recur after a 2 month follow up.

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References

  1. Viskin S, Belhassen B. Polymorphic ventricular tachyarrhythmias in the absence of organic heart disease: classification, differential diagnosis, and implications for therapy. Prog Cardiovasc Dis 1998;41:17-34.
  2. Mechleb BK, Haddadin TZ, Iskandar SB, Abboud LN, Fahrig SA. Idiopathic polymorphic ventricular tachycardia with normal QT interval in a structurally normal heart. Pacing Clin Electrophysiol 2006;29: 791-6. https://doi.org/10.1111/j.1540-8159.2006.00437.x
  3. Haissaguerre M, Shoda M, Jais P, et al. Mapping and ablation of idiopathic ventricular fibrillation. Circulation 2002;106:962-7. https://doi.org/10.1161/01.CIR.0000027564.55739.B1
  4. Haissaguerre M, Extramiana F, Hocini M, et al. Mapping and ablation of ventricular fibrillation associated with long-QT and Brugada syndromes. Circulation 2003;108:925-8. https://doi.org/10.1161/01.CIR.0000088781.99943.95
  5. Weerasooriya R, Hsu LF, Scavee C, et al. Catheter Ablation of Ventricular Fibrillation in Structurally Normal Hearts Targeting the RVOT and Purkinje Ectopy. Herz 2003;28:598-606. https://doi.org/10.1007/s00059-003-2491-y
  6. Ya J, van den Hoff MJ, de Boer PA, et al. Normal development of the outflow tract in the rat. Circ Res 1998;82:464-72. https://doi.org/10.1161/01.RES.82.4.464
  7. Hasdemir C, Aktas S, Govsa F, et al. Demonstration of ventricular myocardial extensions into the pulmonary artery and aorta beyond the ventriculo- arterial junction. Pacing Clin Electrophysiol 2007;30:534-9. https://doi.org/10.1111/j.1540-8159.2007.00704.x

Cited by

  1. Anatomy of the left main coronary artery of particular relevance to ablation of left atrial and outflow tract arrhythmias vol.11, pp.12, 2013, https://doi.org/10.1016/j.hrthm.2014.08.006
  2. Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve vol.31, pp.4, 2016, https://doi.org/10.1007/s00380-015-0653-5
  3. Insights on the pulmonary artery‐derived ventricular arrhythmia vol.29, pp.9, 2013, https://doi.org/10.1111/jce.13652