Inadvertently developed ventricular fibrillation during electrophysiologic study and catheter ablation: Incidence, cause, and prognosis

Yae Min Park, Hyun Soo Lee, Ra Seung Lim, Jongil Choi, Hong Euy Lim, Sang Weon Park, In Suck Choi, Young Hoon Kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and Objectives: Ventricular fibrillation (VF) can inadvertently occur during electrophysiologic study (EPS) or catheter ablation. We investigated the incidence, cause, and progress of inadvertently developed VF during EPS and catheter ablation. Subjects and Methods: We reviewed patients who had developed inadvertent VF during EPS or catheter ablation. Patients who developed VF during programmed ventricular stimulation to induce ventricular tachycardia or VF were excluded. Results: Inadvertent VF developed in 11 patients (46.7±9.3 years old) among 2624 patients (0.42%); during catheter ablation for atrial fibrillation (AF) in nine patients, frequent ventricular premature beats (VPBs) in one, and Wolff-Parkinson-White (WPW) syndrome were observed in one. VF was induced after internal cardioversion in six AF patients due to incorrect R-wave synchronization of a direct current shock. Two AF patients showed spontaneous VF induction during isoproterenol infusion while looking for AF triggering foci. The remaining AF patient developed VF after rapid atrial pacing to induce AF, but the catheter was accidentally moved to the right ventricular (RV) apex. A patient with VPB ablation spontaneously developed VF during isoproterenol infusion. The focus of VPB was in the RV outflow tract and successfully ablated. A patient with WPW syndrome developed VF after rapid RV pacing with a cycle length of 240 ms. Single high energy (biphasic 150-200 J) external defibrillation was successful in all patients, except in two, who spontaneously terminated VF. The procedure was uneventfully completed in all patients. At a mean follow-up period of 17.4±15.5 months, no patient presented with ventricular arrhythmia. Conclusion: Although rare, inadvertent VF can develop during EPS or catheter ablation. Special caution is required to avoid incidental VF during internal cardioversion, especially under isoproterenol infusion.

Original languageEnglish
Pages (from-to)474-480
Number of pages7
JournalKorean Circulation Journal
Volume43
Issue number7
DOIs
Publication statusPublished - 2013 Jul 1

Fingerprint

Catheter Ablation
Ventricular Fibrillation
Incidence
Atrial Fibrillation
Ventricular Premature Complexes
Isoproterenol
Wolff-Parkinson-White Syndrome
Electric Countershock
Ventricular Tachycardia
Cardiac Arrhythmias
Shock

Keywords

  • Catheter ablation
  • Electrophysiologic study, cardiac
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Inadvertently developed ventricular fibrillation during electrophysiologic study and catheter ablation : Incidence, cause, and prognosis. / Park, Yae Min; Lee, Hyun Soo; Lim, Ra Seung; Choi, Jongil; Lim, Hong Euy; Park, Sang Weon; Choi, In Suck; Kim, Young Hoon.

In: Korean Circulation Journal, Vol. 43, No. 7, 01.07.2013, p. 474-480.

Research output: Contribution to journalArticle

Park, Yae Min ; Lee, Hyun Soo ; Lim, Ra Seung ; Choi, Jongil ; Lim, Hong Euy ; Park, Sang Weon ; Choi, In Suck ; Kim, Young Hoon. / Inadvertently developed ventricular fibrillation during electrophysiologic study and catheter ablation : Incidence, cause, and prognosis. In: Korean Circulation Journal. 2013 ; Vol. 43, No. 7. pp. 474-480.
@article{374025c601cf4d5c9feff2c29f2eacca,
title = "Inadvertently developed ventricular fibrillation during electrophysiologic study and catheter ablation: Incidence, cause, and prognosis",
abstract = "Background and Objectives: Ventricular fibrillation (VF) can inadvertently occur during electrophysiologic study (EPS) or catheter ablation. We investigated the incidence, cause, and progress of inadvertently developed VF during EPS and catheter ablation. Subjects and Methods: We reviewed patients who had developed inadvertent VF during EPS or catheter ablation. Patients who developed VF during programmed ventricular stimulation to induce ventricular tachycardia or VF were excluded. Results: Inadvertent VF developed in 11 patients (46.7±9.3 years old) among 2624 patients (0.42{\%}); during catheter ablation for atrial fibrillation (AF) in nine patients, frequent ventricular premature beats (VPBs) in one, and Wolff-Parkinson-White (WPW) syndrome were observed in one. VF was induced after internal cardioversion in six AF patients due to incorrect R-wave synchronization of a direct current shock. Two AF patients showed spontaneous VF induction during isoproterenol infusion while looking for AF triggering foci. The remaining AF patient developed VF after rapid atrial pacing to induce AF, but the catheter was accidentally moved to the right ventricular (RV) apex. A patient with VPB ablation spontaneously developed VF during isoproterenol infusion. The focus of VPB was in the RV outflow tract and successfully ablated. A patient with WPW syndrome developed VF after rapid RV pacing with a cycle length of 240 ms. Single high energy (biphasic 150-200 J) external defibrillation was successful in all patients, except in two, who spontaneously terminated VF. The procedure was uneventfully completed in all patients. At a mean follow-up period of 17.4±15.5 months, no patient presented with ventricular arrhythmia. Conclusion: Although rare, inadvertent VF can develop during EPS or catheter ablation. Special caution is required to avoid incidental VF during internal cardioversion, especially under isoproterenol infusion.",
keywords = "Catheter ablation, Electrophysiologic study, cardiac, Ventricular fibrillation",
author = "Park, {Yae Min} and Lee, {Hyun Soo} and Lim, {Ra Seung} and Jongil Choi and Lim, {Hong Euy} and Park, {Sang Weon} and Choi, {In Suck} and Kim, {Young Hoon}",
year = "2013",
month = "7",
day = "1",
doi = "10.4070/kcj.2013.43.7.474",
language = "English",
volume = "43",
pages = "474--480",
journal = "Korean Circulation Journal",
issn = "1738-5520",
publisher = "Korean Society of Circulation",
number = "7",

}

TY - JOUR

T1 - Inadvertently developed ventricular fibrillation during electrophysiologic study and catheter ablation

T2 - Incidence, cause, and prognosis

AU - Park, Yae Min

AU - Lee, Hyun Soo

AU - Lim, Ra Seung

AU - Choi, Jongil

AU - Lim, Hong Euy

AU - Park, Sang Weon

AU - Choi, In Suck

AU - Kim, Young Hoon

PY - 2013/7/1

Y1 - 2013/7/1

N2 - Background and Objectives: Ventricular fibrillation (VF) can inadvertently occur during electrophysiologic study (EPS) or catheter ablation. We investigated the incidence, cause, and progress of inadvertently developed VF during EPS and catheter ablation. Subjects and Methods: We reviewed patients who had developed inadvertent VF during EPS or catheter ablation. Patients who developed VF during programmed ventricular stimulation to induce ventricular tachycardia or VF were excluded. Results: Inadvertent VF developed in 11 patients (46.7±9.3 years old) among 2624 patients (0.42%); during catheter ablation for atrial fibrillation (AF) in nine patients, frequent ventricular premature beats (VPBs) in one, and Wolff-Parkinson-White (WPW) syndrome were observed in one. VF was induced after internal cardioversion in six AF patients due to incorrect R-wave synchronization of a direct current shock. Two AF patients showed spontaneous VF induction during isoproterenol infusion while looking for AF triggering foci. The remaining AF patient developed VF after rapid atrial pacing to induce AF, but the catheter was accidentally moved to the right ventricular (RV) apex. A patient with VPB ablation spontaneously developed VF during isoproterenol infusion. The focus of VPB was in the RV outflow tract and successfully ablated. A patient with WPW syndrome developed VF after rapid RV pacing with a cycle length of 240 ms. Single high energy (biphasic 150-200 J) external defibrillation was successful in all patients, except in two, who spontaneously terminated VF. The procedure was uneventfully completed in all patients. At a mean follow-up period of 17.4±15.5 months, no patient presented with ventricular arrhythmia. Conclusion: Although rare, inadvertent VF can develop during EPS or catheter ablation. Special caution is required to avoid incidental VF during internal cardioversion, especially under isoproterenol infusion.

AB - Background and Objectives: Ventricular fibrillation (VF) can inadvertently occur during electrophysiologic study (EPS) or catheter ablation. We investigated the incidence, cause, and progress of inadvertently developed VF during EPS and catheter ablation. Subjects and Methods: We reviewed patients who had developed inadvertent VF during EPS or catheter ablation. Patients who developed VF during programmed ventricular stimulation to induce ventricular tachycardia or VF were excluded. Results: Inadvertent VF developed in 11 patients (46.7±9.3 years old) among 2624 patients (0.42%); during catheter ablation for atrial fibrillation (AF) in nine patients, frequent ventricular premature beats (VPBs) in one, and Wolff-Parkinson-White (WPW) syndrome were observed in one. VF was induced after internal cardioversion in six AF patients due to incorrect R-wave synchronization of a direct current shock. Two AF patients showed spontaneous VF induction during isoproterenol infusion while looking for AF triggering foci. The remaining AF patient developed VF after rapid atrial pacing to induce AF, but the catheter was accidentally moved to the right ventricular (RV) apex. A patient with VPB ablation spontaneously developed VF during isoproterenol infusion. The focus of VPB was in the RV outflow tract and successfully ablated. A patient with WPW syndrome developed VF after rapid RV pacing with a cycle length of 240 ms. Single high energy (biphasic 150-200 J) external defibrillation was successful in all patients, except in two, who spontaneously terminated VF. The procedure was uneventfully completed in all patients. At a mean follow-up period of 17.4±15.5 months, no patient presented with ventricular arrhythmia. Conclusion: Although rare, inadvertent VF can develop during EPS or catheter ablation. Special caution is required to avoid incidental VF during internal cardioversion, especially under isoproterenol infusion.

KW - Catheter ablation

KW - Electrophysiologic study, cardiac

KW - Ventricular fibrillation

UR - http://www.scopus.com/inward/record.url?scp=84883260631&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84883260631&partnerID=8YFLogxK

U2 - 10.4070/kcj.2013.43.7.474

DO - 10.4070/kcj.2013.43.7.474

M3 - Article

C2 - 23964294

AN - SCOPUS:84883260631

VL - 43

SP - 474

EP - 480

JO - Korean Circulation Journal

JF - Korean Circulation Journal

SN - 1738-5520

IS - 7

ER -