Aspirated air in the pericardial space during epicardial catheterization may elevate the defibrillation threshold

Takumi Yamada, H. Thomas McElderry, Michael Platonov, Harish Doppalapudi, G. Neal Kay

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

A 79-year-old woman without structural heart disease underwent catheter ablation of ventricular tachycardia. Successful ablation was achieved on the left ventricular epicardium using an epicardial approach via pericardial puncture. Thereafter, programmed stimulation induced ventricular fibrillation (VF). A 360 J biphasic extrathoracic cardioversion using cutaneous pads in the conventional sternal-apical position failed to terminate the VF. After repositioning the sternal pad more laterally, the 360 J biphasic shock terminated the VF. Fluoroscopic imaging revealed aspirated air in the pericardial space, mainly apically. In this case, air aspirated into the pericardial space during the epicardial approach might have elevated the defibrillation threshold.

Original languageEnglish (US)
Pages (from-to)e34-e35
JournalInternational Journal of Cardiology
Volume135
Issue number1
DOIs
StatePublished - Jun 12 2009
Externally publishedYes

Bibliographical note

Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.

Keywords

  • Defibrillation threshold
  • Epicardial
  • Pericardial air
  • Radiofrequency catheter ablation

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