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Intermittent Claudication Caused by Frequent Premature Ventricular Complexes: Resolution After Radiofrequency Ablation

Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland, smstec{at}wp.pl

Beata Zaborska, MD

Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland

Agnieszka Pilu, MD

Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland

Pawe Lewandowski, MD

Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland

Piotr Kuakowski, MD, PhD

Department of Cardiology, Postgraduate Medical School, Grochowski Hospital, Warsaw, Poland

A case of a 55-year-old woman with psoriasis and long-lasting history of typical intermittent claudication associated with frequent premature ventricular complexes is reported. Atherosclerotic and nonarterial pathologic conditions were taken into consideration and were excluded. Applying 6-minute walk test and resting and peak-exercise pulsed Doppler ultrasonography, it was possible to prove a decrease in perfusion during exercise-persistent ventricular bigeminy. Rapid improvement in symptoms was observed after a single dose of propafenone; however, it led to a worsening of psoriasis. The patient was referred for radiofrequency ablation. Radiofrequency ablation in the right ventricular outflow tract resulted in complete abolition of premature ventricular complexes and intermittent claudication. The patient remained free of claudication and symptoms related to arrhythmia with an ability to walk more than 5 km, without stopping. Relief of symptoms may be achieved by antiarrhythmic treatment; however, side effects of antiarrhythmic drugs or their ineffectiveness should encourage the use of radiofrequency ablation.

Key Words: electrophysiology—clinical • ablation • premature ventricular complexes • intermittent claudication • 6-minute walk test

This version was published on June 1, 2009

Angiology, Vol. 60, No. 3, 378-381 (2009)
DOI: 10.1177/0003319707312520


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