Coved‐type ST‐elevation during ablation of ischemic ventricular tachycardia

Abstract

A coved-type electrocardiogram (ECG) change in Brugada syndrome is suggested to be the result of abnormally delayed depolarization over the right ventricular outflow tract; however, ischemia of the conus branch of the right coronary artery presents the same ECG change. A 63-year-old man with a history of myocardial infarction demonstrated a transient coved-type ECG change during catheter ablation of ventricular tachycardia. The ECG change appeared during left ventricular mapping without any chest symptoms, and recovered spontaneously. A pilsicainide test was negative and a coved-type ECG did not appear during the perioperative or follow-up period.

ST‐segment elevation during arrhythmia ablations—A review

“…Transient STE during ablation of ventricular tachycardia was first documented in 2015 in a patient with ischemic ventricular ablation who demonstrated coved‐STE in leads V1 and V2 after transseptal puncture 17 . The case report by Hori et al was subsequently re‐evaluated by Gottschalk et al, as the STE did not occur in the predicted inferior leads as in other transseptal ablation case reports.…”

Ischemic Brugada phenocopy during ablation of ventricular tachycardia

“…We examined the report by Hori et al with specific interest in their description of a Brugada ECG (electrocardiogram) pattern observed during ablation of ventricular tachycardia (VT) [1]. Their case provides an important contribution to an expanding database of ischemic Brugada phenocopies (BrP) [2,3].…”

“…The authors [1] presented the case of a 63-year-old man undergoing catheter ablation of ischemic VT. The patient developed a Type-1 Brugada ECG pattern during the procedure, resolving upon observation within two minutes.…”