Monomorphic ventricular tachycardia related to Wolff-Parkinson-White surgery

Ventricular ectopy following accessory pathway ablation in WPW syndrome

INTRODUCTION

Many Authors already described automatic activity arising from accessory pathways, but the underlying mechanism has not been clarified yet. They may be due to embryogenetic features of myocardium or may be related to specific excitability during radiofrequency ablation.

CASE

Our report shows that ventricular accelerated rhythm may transiently arise from the ventricular edge of a common myocardium made accessory pathway right after the ablation. No further action were required in our experience, since the phenomenon self extinguished in approximately hour.

CONCLUSIONS

If this manifestation represents the effect of thermal injury or if it is a real intrinsic automaticity is not fully documented and may need further reporting and investigation.

Monomorphic ventricular tachycardia 25 years post surgical ablation for Wolff-Parkinson-White

The first surgical ablation of an accessory pathway for the treatment of Wolff-Parkinson-White (WPW) syndrome was performed in 1968, and surgery remained first-line therapy until the advent of catheter ablation techniques in the early 1990s. Current indications for surgical ablation of WPW syndrome are limited to ablation failures. To this day, there has been no long-term follow-up of these surgically treated patients. We describe the case of a man, aged 54 years, who developed ventricular tachycardia 25 years after surgical ablation of WPW. This is first reported case of ventricular tachycardia following an epicardial surgical cryoablation technique for WPW.