Ablation strategies in a patient with Belhassen tachycardia

作者：Emmel Mathias^*; Sreeram Nayaranswami; Khalil Markus; Adelmann Roland; Brockmeier Konrad

来源：Journal of Electrocardiology, 2011, 44(6): 802-805.

DOI：10.1016/j.jelectrocard.2011.02.003

The verapamil-sensitive Belhassen tachycardia is a ventricular reentrant tachycardia, involving left-sided Purkinje fibers and abnormal Purkinje or myocardial tissue. Ablation is feasible, targeting a diastolic fascicular potential in the apical left ventricle.
Case report: We report on a 13-year-old girl with left posterior fascicular ventricular tachycardia. Tachycardia stopped during ablation, targeting a left-sided distal fascicular potential, and afterward, there was no tachycardia inducible, but it reoccurred 2 weeks later. During a second procedure, we transected the left posterior fascicle by a line, also with early success. After a further recurrence, we ablated a longer proximal segment of the left posterior fascicle including its most proximal electrograms. After this ablation, there was no further recurrence.
Conclusion: In refractory patients, proximal ablation of the posterior fascicle might be indicated.

• 出版日期2011-12