Benefits of effective multidisciplinary teamwork: catheter ablation of premature ventricular ectopics

2020 ◽  
Vol 13 (5) ◽  
pp. e233411
Author(s):  
John Daveney ◽  
Thomas Nguyen ◽  
Matt Wright
Keyword(s):  
Catheter Ablation ◽  
Right Ventricular Outflow Tract ◽  
Interventional Cardiology ◽  
Ventricular Outflow Tract ◽  
Successful Outcome ◽  
Beta Blockade ◽  
Premature Ventricular Contractions ◽  
History Of ◽  
Ventricular Ectopics ◽  
Multidisciplinary Teamwork

The case concerns a difficult but successful right ventricular outflow tract ectopy catheter ablation in a fit and well 33-year-old man with a 16-year history of symptomatic premature ventricular contractions (PVCs). Beta blockade medication had become ineffective in suppressing the PVCs, and a 24-hour Holter monitor revealed a high burden of ectopy (10%). An echocardiogram and cardiac MRI showed a structurally normal heart. During the procedure, it became impossible to uncurve the catheter, and it lodged in the patient’s right femoral artery. Immediate collaboration with interventional cardiology and interventional radiology was required to resolve the issue. The case demonstrates that excellent teamwork and calling rapidly on input from subspecialties are integral to overcoming unexpected events and to achieve a safe and successful outcome. The patient involved was a medical student at the time and as one of the coauthors offers a unique insight.

Transcatheter pulmonary valve insertion, expanded use (beyond large conduits from the right ventricle to pulmonary artery), and future directions

2014 ◽  
Vol 24 (6) ◽  
pp. 1095-1100 ◽  
Author(s):  
Jeremy M. Ringewald ◽  
Elsa J. Suh
Keyword(s):  
Pulmonary Valve ◽  
Right Ventricular Outflow Tract ◽  
Interventional Cardiology ◽  
Ventricular Outflow Tract ◽  
Future Directions ◽  
United States Food ◽  
History Of ◽  
States Food ◽  
The Right

AbstractTranscatheter pulmonary valve insertion is the most important advance in congenital interventional cardiology since atrial septal defect devices became commonly available 15 years ago. It has changed the way we look at a number of diverse diagnoses and changes how we plan, diagnose, operate, and follow-up patients. It has changed how we counsel families expecting a child that may benefit from it. Expanded use of the Melody® valve, outside its United States Food and Drug Administration approved indications, has helped numerous additional patients. The use of transcatheter pulmonary valve insertion in selected patients following surgical Gore-tex® bileaflet in valve right ventricular outflow tract reconstruction and those with a history of prior small homograft conduits will be discussed.

scholarly journals Vitamin D as a Substitute of Catheter Ablation in a Paediatric Patient with High Burden Premature Ventricular Contractions: A Case Report

2021 ◽  
Author(s):  
Gabriel Cismaru ◽  
Cecilia Lazea ◽  
Simona Cainap ◽  
Daniela Iacob
Keyword(s):  
Vitamin D ◽  
Catheter Ablation ◽  
Vitamin D Deficiency ◽  
Right Ventricular Outflow Tract ◽  
Dietary Supplementation ◽  
Ventricular Outflow Tract ◽  
Premature Ventricular Contractions ◽  
Holter Ecg ◽  
Cardiology Department ◽  
Coronary Artery Injury

Catheter ablation is established as a treatment option for patients with high number Premature Ventricular Contractions (PVCs). However, complications can occur: cardiac tamponade, coronary artery injury or infectious endocarditis. Reversible causes such as hypocalcaemia, hypomagnesaemia and hypokalemia can be responsible for PVCs. Here, a case of nine years old boy, with vitamin D deficiency that presented high number PVCs which corrected using vitamin D dietary supplementation was described. A nine-year-old boy was hospitalised in the Cardiology Department for catheter ablation of PVCs. He presented short of breath during football matches and asthenia. Electrocardiography(ECG) and Holter ECG demonstrated high number PVCs with a morphology consistent of Right Ventricular Outflow Tract (RVOT) origin. Catheter ablation was postponed until Vitamin D came to normal values. Dietary supplementation was performed, together with Holter ECG monitoring. After vitamin D normalisation, PVC burden reduced significantly without the need of catheter ablation or anti-arrhythmic drugs. Catheter ablation and anti-arrhythmic drugs can be avoided in patients with frequent PVCs and vitamin D deficiency.

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