Recurrent ventricular tachycardia from severe aortic stenosis improves after percutaneous aortic balloon valvuloplasty and transcatheter aortic valve replacement

Abstract

We report a case of recurrent ventricular tachycardia from severe aortic stenosis that improved after percutaneous aortic balloon valvuloplasty and transcatheter aortic valve replacement. The electrocardiographic features of the arrhythmia were compatible with ventricular tachycardia originating from the left ventricle. Myocardial ischemia and electrolyte abnormalities were ruled out. Clinicians should be aware that recurrent left ventricular tachycardia associated with severe aortic stenosis is a potentially reversible condition by transcatheter intervention. <Learning objective: Calcific aortic stenosis is a common problem in the elderly. There is a high prevalence of ventricular arrhythmias in these patients. Transcatheter aortic valve replacement is a relatively new procedure for high-risk patients with severe aortic stenosis. We report a case that illustrates for the first time resolution of recurrent ventricular tachycardia after percutaneous aortic balloon valvuloplasty and transcatheter aortic valve replacement in an elderly patient with severe aortic stenosis.>

Clinical Significance of Ventricular Tachyarrhythmias in Patients Undergoing Valve Replacement: A Nationwide Population-Based Study

“…The correlation between VTa and left ventricular (LV) dysfunction in patients with VHD has also been reported in several studies (21)(22)(23)(24)(25)(26)(27). Chronic pressure or volume overload of the myocardium could increase ventricular wall stress and structural remodeling, which subsequently enhances the formation of arrhythmogenic substrates even after surgical valve replacement, despite the fact that regression of ventricular arrhythmia in consonance with the improvement of LV systolic function has been reported after valve replacement (28)(29)(30).…”

Insights into calcific aortic valve stenosis: a comprehensive overview of the disease and advancing treatment strategies

“…Heyde syndrome, a well-known cardiac manifestation of CAVD, has been reported to present with iron deficiency anemia, possibly due to chronic gastrointestinal blood loss from the angiodysplasias that develop due to the disease 55 . A case of recurrent ventricular arrhythmias has been noted in association with a calcified AV, which demonstrated resolution after AV reimplantation, indicating that such arrhythmias could be sequelae of AV calcifications 56 . A similar case of syncope due to paroxysmal AV block was also noted to be associated with calcified AV.…”