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Electrical storm in systemic sclerosis: Inside the electroanatomic substrate
Journal article

Electrical storm in systemic sclerosis: Inside the electroanatomic substrate

Michela Casella, Corrado Carbucicchio, Eleonora Russo, Francesca Pizzamiglio, Paolo Golia, Sergio Conti, Fabrizio Costa, Antonio Dello Russo and Claudio Tondo
World journal of cardiology, Vol.6(10), pp.1127-1130
10/26/2014
DOI: 10.4330/wjc.v6.i10.1127
PMCID: PMC4209440
PMID: 25349658

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Abstract

We report the case of a 63-year-old woman affected by a severe form of systemic scleroderma with pulmonary involvement (interstitial fibrosis diagnosed by biopsy and moderate pulmonary hypertension) and cardiac involvement (paroxysmal atrial fibrillation, right atrial flutter treated by catheter ablation, ventricular tachyarrhythmias, previous dual chamber implantable cardioverter defibrillator implant). Because of recurrent electrical storms refractory to iv antiarrhythmic drugs the patient was referred to our institution to undergo catheter ablation. During electrophysiological procedure a 3D shell of cardiac anatomy was created with intracardiac echocardiography pointing out a significant right ventricular dilatation with a complex aneurysmal lesion characterized by thin walls and irregular multiple trabeculae. A substrate-guided strategy of catheter ab-lation was accomplished leading to a complete electrical isolation of the aneurism and to the abolishment of all abnormal electrical activities. The use of advanced strategies of imaging together with electroanatomical mapping added important information to the complex arrhythmogenic substrate and improved efficacy and safety. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Science & Technology

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