Transcoronary chemical ablation of ventricular tachycardia in chronic chagasic myocarditis
AA de Paola,
JA Gomes,
MH Miyamoto,
and
EE Fo
Division of Clinical Cardiac Electrophysiology, Hospital Sao Paulo, Escola Paulista de Medicina, Brazil.
OBJECTIVE. A case of incessant ventricular tachycardia in a patient with Chagas' disease that was successfully terminated by chemical ablation is reported. BACKGROUND. Chagas' disease is a common medical problem in South America. Ventricular tachyarrhythmias, atrioventricular conduction disturbances, congestive heart failure and sudden cardiac death are important manifestations of this disease. METHODS. Selective catheterization of the coronary artery supplying the arrhythmogenic area was performed by using a conventional angioplasty system and the arrhythmogenic area was ablated by injection of 96% sterile ethanol. RESULTS. Ethanol (96%) injection initially in a lateral branch of the left circumflex artery and 2 days later in the proximal segment of the artery resulted in termination of ventricular tachycardia. Two weeks after ablation, programmed ventricular stimulation failed to induce ventricular tachycardia. CONCLUSION. Transcoronary chemical ablation should be considered in selected cases of Chagas' disease with incessant ventricular tachycardia.
