Utilization of Coronary Venous Ethanol Ablation for Intramural Ventricular Arrhythmias in Two Different Scenarios: A How-To Approach.

Emir Baskovski, İrem Cenan Büyükçakır, Timuçin Altın, Ömer Akyürek
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Abstract

Catheter-based radiofrequency (RF) ablation is a recommended treatment modality for various ventricular arrhythmias. However, challenging sites that may not be accessible due to anatomical reasons, as well as intramural sites, where RF energy penetration may be limited, pose challenges that limit the success rate of RF ablation. Ethanol ablation may be an alternative option for treatment of ventricular arrhythmias that are not amenable to treatment by RF ablation. This report describes two cases of successful venous alcohol ablation for refractory ventricular tachycardia to standard RF ablation procedure. In the first case, a patient with a ventricular tachycardia (VT) originating from intramural outflow tract, having failed an endocardial ablation, underwent a successful ethanol ablation, via a double balloon technique. In the second case, we describe a patient with a history of transcatheter aortic valve replacement and premature ventricular complexes (PVCs) originating from intramural outflow tract. Radiofrequency ablation in this patient was limited by both the far-field appearing signals and the proximity prosthetic valve to the site of these signals. Therefore, this patient also underwent successful ethanol ablation of annular vein with the over the wire system after venography of coronary sinus. No complications were observed in both patients. In conclusion, coronary venous ethanol ablation may be a safe and successful technique for ablation of intramural ventricular arrhythmias in different clinical scenarios.

两种不同情况下冠状静脉乙醇消融治疗室性心律失常的应用:操作方法。
导管射频消融是各种室性心律失常的推荐治疗方式。然而,由于解剖原因可能无法进入的具有挑战性的部位,以及射频能量穿透可能有限的内部部位,构成了限制射频消融成功率的挑战。乙醇消融可能是治疗不适合射频消融治疗的室性心律失常的另一种选择。本报告描述了两个成功的静脉酒精消融治疗难治性室性心动过速的标准射频消融程序。在第一例病例中,一位室性心动过速(VT)起源于壁内流出道的患者,在心内膜消融失败后,通过双球囊技术成功地进行了乙醇消融。在第二个病例中,我们描述了一个有经导管主动脉瓣置换术和室性早搏(室性早搏)起源于壁内流出道病史的患者。该患者的射频消融受到远场出现信号和人工瓣膜靠近这些信号部位的限制。因此,该患者在冠状静脉窦造影后,也成功地进行了环静脉的乙醇消融。两例患者均无并发症发生。总之,在不同的临床情况下,冠状静脉乙醇消融可能是一种安全、成功的治疗室性心律失常的技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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