Cardiomyopathy Due to Nonsustained Ventricular Tachycardia Originating from the Aortic Sinus Cusp

Hamidreza  Bonakdar; Mohammad  Assadian Rad; Jalal  Kheirkhah; Anoush  Barzigar

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Cardiomyopathy Due to Nonsustained Ventricular Tachycardia Originating from the Aortic Sinus Cusp

Author(s):

Hamidreza Bonakdar^1,*,

Mohammad Assadian Rad¹,

Jalal Kheirkhah ¹,

Anoush Barzigar¹

1Department of Pacemaker and Electrophysiology, Heshmat Cardiovascular Center, Guilan University of Medical Sciences, Rasht, Iran

International Cardiovascular Research Journal:Vol. 7, issue 1; e12727

Published online:Mar 31, 2013

Article type:Case Report

Received:May 07, 2017

Accepted:Jan 11, 2013

How to Cite:Hamidreza Bonakdar Mohammad Assadian RadJalal Kheirkhah Anoush BarzigarCardiomyopathy Due to Nonsustained Ventricular Tachycardia Originating from the Aortic Sinus Cusp.Int Cardiovasc Res J.7(1):e12727.

Abstract

We report a case of idiopathic nonsustained ventricular tachycardia (VT) originating from the aortic sinus cusp referred for presyncope and LV dysfunction and frequent premature ventricular complex with no response to 3 months anti-arrhythmic medication for heart failure and arrhythmia. She was then referred to us for frequent PVC's and runs of nonsustained VT. ECG recorded during the nonsustained VT showed a left bundle branch block pattern in the precordial leads and an inferior axis and early transition in precordial leads in V3-V4. QS morphology in lead V1 was noticed with notching on the downward deflection. Electrophysiologic study was conducted to map ventricular outflow tract as a classic method, although pace map failed to find any matched QRS with the spontaneous PVCs. The mapping of aortic cusps was also performed. The best potential was recorded in a region located at the commissure of left-right aortic cusps. A single radiofrequency energy was delivered which resulted in immediate elimination of PVCs. The patient was discharged the day after ablation without any PVC recorded on monitor. Left ventricular ejection fraction(LVEF) improved to normal level two months later. There was no PVC detected at serial holter monitoring. It seems logical not to overlook even an isolated or nonsustained ventricular arrhythmia considering the available and effective treatments such as ablation rather than congestive heart failure(CHF) therapy especially in a young patient.

Keywords

Electrophysiology

Radiofrequency Ablation

PVC

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