Successful elimination of ischemic ventricular tachycardia from the left ventricle using a non-fluoroscopic navigation system in a patient with a cardioverter-implanted defibrillator

Authors: Avanesyan G.A., Filatov A.G., Shalov R.Z., Kovalev A.S., Saparbaev A.A.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Case reports


For citation: Avanesyan G.A., Filatov A.G., Shalov R.Z., Kovalev A.S., Saparbaev A.A. Successful elimination of ischemic ventricular tachycardia from the left ventricle using a non-fluoroscopic navigation system in a patient with a cardioverter-implanted defibrillator. Creative Cardiology. 2021; 15 (4): 547–54 (in Russ.). DOI: 10.24022/1997-3187-2021-15-4-547-554

Received / Accepted:  22.08.2021 / 15.12.2021

Keywords: ventricular tachycardia radiofrequency ablation postinfarction ventricular tachycardia

Full text:  



Ventricular arrhythmias account for about 20% of all tachyarrhythmias and are the most dangerous cardiac arrhythmia. The purpose of this report is to demonstrate a clinical case of successful treatment of frequent polymorphic ventricular tachycardia in a patient after extensive left ventricular myocardial infarction. In this patient, persistently recurrent paroxysms of ventricular tachycardia/ventricular fibrillation were observed after implantation of a cardioverter-defibrillator and twice performed radiofrequency ablation of ventricular tachycardia, antiarrhythmic therapy was ineffective. The patient underwent reoperation using advanced non-fluoroscopic imaging systems. The operation resulted in successful elimination of the arrhythmogenic focus in the left ventricle and relief of ventricular tachycardia/ventricular fibrillation, which was confirmed 2 months later when testing an implantable cardioverter-defibrillator.


  1. Liu X., Adhikari B.K., Chen T., Wang Y., Liu Q., Wang S. Ventricular fibrillation storm after revascularization of chronic total occlusion of the left anterior descending artery: is this reperfusion arrhythmia? J. Int. Med. Res. 2021; 49 (3): 300060521997618. DOI: 10.1177/0300060521997618
  2. Sesselberg H.W., Moss A.J., McNitt S., Zareba W., Daubert J.P., Andrews M.L et al. MADIT-II Research Group. Ventricular arrhythmia storms in postinfarction patients with implantable defibrillators for primary prevention indications: a MADITII substudy. Heart Rhythm. 2007; 4 (11): 1395–402. DOI: 10.1016/j.hrthm.2007.07.013
  3. Friedman D.J., Altman R.K., Orencole M., Picard M.H., Ruskin J.N., Singh J.P. et al. Predictors of sustained ventricular arrhythmias in cardiac resynchronization therapy. Circ. Arrhythm. Electrophysiol. 2012; 5 (4): 762–72. DOI: 10.1161/ CIRCEP.112.971101
  4. Sweeney M.O., Sherfesee L., DeGroot P.J., Wathen M.S., Wilkoff B.L. Differences in effects of electrical therapy type for ventricular arrhythmias on mortality in implantable cardioverter-defibrillator patients. Heart Rhythm. 2010; 7 (3): 353–60. DOI: 10.1016/j.hrthm.2009.11.027
  5. Tatarsky R.B., Mikhailov E.N., Lebedeva V.K., Lebedev D.S. Urgent catheter ablation of the electrical storm in patients with implanted cardioverter-defibrillator. Russian Journal of Cardiology. 2015; 11: 57–62 (in Russ.). DOI: 10.15829/1560-4071-2015-11-57-62
  6. Steven D., van den Bruck J.H., Lüker J., Plenge T., Sultan A. 3-D-Mapping ventrikulürer Tachyarrhythmien bei dilatativer Kardiomyopathie [3-D mapping of ventricular tachycardia in patients with dilative cardiomyopathy]. Herzschrittmacherther Elektrophysiol. 2017; 28 (2): 206-211. German. DOI: 10.1007/s00399-017-0511-5
  7. Ebert M., Richter S., Dinov B., Zeppenfeld K., Hindricks G. Evaluation and management of ventricular tachycardia in patients with dilated cardiomyopathy. Heart Rhythm. 2019; 16 (4): 624–31. DOI: 10.1016/j.hrthm.2018.10.028
  8. Sapp J.L., Wells G.A., Parkash R., Stevenson W.G., Blier L., Sarrazin J.F. et al. Ventricular Tachycardia Ablation versus Escalation of Antiarrhythmic Drugs. N. Engl. J. Med. 2016; 375 (2): 111–21. DOI: 10.1056/NEJMoa1513614
  9. Cronin E.M., Bogun F.M., Maury P., Peichl P., Chen M., Namboodiri N. et al. 2019 HRS/EHRA/ APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias. J. Interv. Card. Electrophysiol. 2020; 59 (1): 145–298. DOI: 10.1007/s10840-019-00663-3
  10. Anderson R.D., Ariyarathna N., Lee G., Virk S., Trivic I., Campbell T. et al. Catheter ablation versus medical therapy for treatment of ventricular tachycardia associated with structural heart disease: Systematic review and meta-analysis of randomized controlled trials and comparison with observational studies. Heart Rhythm. 2019; 16 (10): 1484–91. DOI: 10.1016/j.hrthm.2019.05.026

About Authors

  • Grayr A. Avanesyan, Postgraduate; ORCID
  • Andrey G. Filatov, Dr. Med. Sci., Head of Department; ORCID
  • Ruslan Z. Shalov, Cand. Med. Sci., Researcher; ORCID
  • Aleksey S. Kovalev, Cand. Med. Sci., Researcher; ORCID
  • Aydin A. Saparbaev, Junior Researcher; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery