Trans-subclavian approach for radiofrequency ablation of premature ventricular contractions originating from subtricuspid annulus: a case report

BMC Cardiovascular Disorders

Case Report

Yu-mei Xue¹  Ping-zhen Yang¹  Hong-tao Liao¹  Shu-lin Wu¹  Xian-zhang Zhan¹  Xian-hong Fang¹  Teng Li² 

[1] Cardiovascular Department, Guangdong Cardiovascular Institute, Guangdong General Hospital, No. 96, Dongchuan Road, 510080, Guangzhou, China;Cardiovascular Department, Guangdong Cardiovascular Institute, Guangdong General Hospital, No. 96, Dongchuan Road, 510080, Guangzhou, China;Department of Cardiology, Affiliated hospital of Guangdong Medical College, No. 57, Renming Road, 524001, Zhanjiang, China;

关键词: Premature ventricular contractions;    Tricuspid annulus;    Radiofrequency catheter ablation;   

DOI  :  10.1186/1471-2261-13-7

 received in 2012-08-21, accepted in 2013-01-30,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundCatheter ablation has been established as a curative treatment strategy for ventricular arrhythmias. The standard procedure of most ventricular arrhythmias originating from the right ventricle is performed via the femoral vein. However, a femoral vein access may not achieve a successful ablation in some patients.Case presentationWe reported a case of a 29-year old patient with symptomatic premature ventricular contractions was referred for catheter ablation. Radiofrequency energy application at the earliest endocardial ventricular activation site via the right femoral vein could not eliminate the premature ventricular contractions. Epicardial mapping could not obtain an earlier ventricular activation when compared to the endocardial mapping, and at the earliest epicardial site could not provide an identical pace mapping. Finally, we redeployed the ablation catheter via the right subclavian vein by a long sheath. During mapping of the subvalvular area of the right ventricle, a site with a good pace mapping and early ventricular activation was found, and premature ventricular contractions were eliminated successfully.ConclusionVentricular arrhythmias originating from the subtricuspid annulus may be successfully abolished via a trans-subclavian approach and a long sheath. Although access via the right subclavian vein for mapping and ablation is an effective alternative, it is not a routine approach.

【 授权许可】

Unknown   
© Li et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.