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Catheter ablation of premature ventricular contraction-induced cardiomyopathy

Nature Clinical Practice Cardiovascular Medicine volume 5, pages 289–293 (2008)Cite this article

Abstract

Background A 44-year-old female presented with a long history of chest pain, palpitations and increasing dyspnea. Electrocardiography and 24 h Holter monitoring revealed multiple premature ventricular complexes (PVCs), and echocardiography demonstrated significant left ventricular dilatation and systolic impairment. After further investigation it was concluded that this cardiomyopathy was secondary to the observed multiple PVCs and that these represented a potential target for treatment.

Investigations Electrocardiography, echocardiography, cardiac MRI, 24 h Holter monitoring, coronary angiography, tilt testing and invasive electrophysiological testing using a multielectrode array catheter.

Diagnosis PVC-induced dilated cardiomyopathy.

Management Electrophysiological mapping and cryoablation of the focus of the ventricular ectopy.

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Figure 1: Investigations undertaken at presentation demonstrated that the patient was experiencing frequent premature ventricular complexes originating from the right ventricular outflow tract.
Figure 2: Invasive electrophysiological testing was performed with the multielectrode array positioned in the right ventricular outflow tract, with the aim of mapping and ablating the focus of the patient's ventricular ectopy.
Figure 3: Intracardiac and surface electrocardiograms, recorded at the ablation site during the procedure, showing a sinus beat followed by a premature ventricular complex.

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Author information

Authors and Affiliations

  1. VA Ezzat is a Specialist Registrar in Cardiology at Princess Alexandra Hospital, Harlow,

    Vivienne A Ezzat

  2. R Liew is a Specialist Registrar in Cardiology at St Bartholomew's Hospital and DE Ward is a Cardiology Consultant and Director of Cardiac Electrophysiological Services at St George's Hospital, London, UK.,

    Reginald Liew & David E Ward

Authors
  1. Vivienne A Ezzat
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  2. Reginald Liew
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  3. David E Ward
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Corresponding author

Correspondence to Vivienne A Ezzat.

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Competing interests

The authors declare no competing financial interests.

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Ezzat, V., Liew, R. & Ward, D. Catheter ablation of premature ventricular contraction-induced cardiomyopathy. Nat Rev Cardiol 5, 289–293 (2008). https://doi.org/10.1038/ncpcardio1180

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