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Ann Thorac Surg 2009;87:631-633. doi:10.1016/j.athoracsur.2008.06.065
© 2009 The Society of Thoracic Surgeons
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Fernando A. Atik
Cristiano N. Faber
Ricardo B. Corso
Luiz Fernando Caneo
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Case Reports

Recurrent Ventricular Arrhythmia After Coronary Artery Bypass Grafting Treated With Radiofrequency Catheter Ablation

Fernando A. Atik, MDa,*, Maria Fernanda M. Garcia, MDb, Jose Mario Baggio, Jr, MDb,c, Cristiano N. Faber, MDa, Ricardo B. Corso, MDa, Luiz Fernando Caneo, MDa, Alvaro V. Sarabanda, MDb,c

a Department of Cardiovascular Surgery, Heart Institute of Federal District, Zerbini Foundation, Brasilia, Brazil
b Department of Cardiology, Heart Institute of Federal District, Zerbini Foundation, Brasilia, Brazil
c Department of Clinical Arrhythmia and Pacemaker Unit, Heart Institute of Federal District, Zerbini Foundation, Brasilia, Brazil

Accepted for publication June 19, 2008.

* Address correspondence to Dr Atik, Heart Institute of Federal District, Zerbini Foundation, Estrada Parque Contorno do Bosque s/n, 1 Andar, Sala 13, Brasília-DF, 70658-700, Brazil (Email: fernando.atik{at}incordf.zerbini.org.br).

A 63-year-old diabetic woman was emergently submitted to coronary artery bypass grafting in the setting of acute myocardial infarction. Recurrent, drug-refractory episodes of ventricular arrhythmia occurred for 2 weeks postoperatively, despite no documentation of ongoing myocardial ischemia and optimum medical treatment. Ventricular arrhythmia was initiated by premature ventricular contractions originating from the Purkinje system within the infarct border zone. Radiofrequency catheter ablation was performed at sites where Purkinje potentials were recorded, leading to arrhythmia cessation. A week later, an implantable cardioverter defibrillator was inserted and she was discharged home a few days later. At 15-month follow-up, there were no further episodes of arrhythmia and ventricular function had improved.






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