Long-term follow-up after radiofrequency catheter ablation of ventricular tachycardia: a successful approach?

Abstract:

INTRODUCTION:Radiofrequency ablation (RFCA) of ventricular tachycardia (VT) is a potential curative treatment modality. We evaluated the results of RFCA in patients with VT. METHODS AND RESULTS:One hundred fifty-one consecutive patients (122 men and 29 women; age 57 +/- 16 years) with drug-refractory VT were treated. Underlying heart disease was ischemic heart disease in 89 (59%), arrhythmogenic right ventricular cardiomyopathy (ARVC) in 32 (21%), and idiopathic VT in 30 (20%; left ventricle in 9 [30%]; right ventricle in 21 [70%]). Ablation was performed using standard ablation techniques. Three hundred six different VTs were treated (cycle length 334 +/- 87 msec, 2.0 +/- 1.4 VTs per patient). Procedural success (noninducibility of VT after RFCA) was achieved in 126 (83%) patients (70 ischemic heart disease [79%]; 28 ARVC [88%]; 27 idiopathic VT [93%]). Procedure-related complications (< 48 hours) occurred in 11 (7%) patients: death 3 (2.0%), cerebrovascular accident 2 (1.3%), complete heart block 4 (2.6%), and pericardial effusion 3 (2.0%). Thirty-three (22%) patients received an implantable cardioverter defibrillator (because of hemodynamic unstable VT, failure of the procedure, or aborted sudden death). During follow-up (34 +/- 11 months), VT recurrences occurred in 38 (26%) patients (recurrence rate: 19% in successfully ablated patients and 64% in nonsuccessfully ablated patients; P < 0.001). During follow-up, 12 (8%) patients died (heart failure 8, unknown cause 1, noncardiac cause 3). CONCLUSION:RFCA of VT can be performed with a high degree of success (83%). The long-term outcome of successfully ablated patients is promising, with a 75% relative risk reduction compared with nonsuccessfully ablated patients. During follow-up, only one patient died suddenly, supporting a selective ICD placement approach in patients with hemodynamically stable VT.

authors

Borger van der Burg AE,de Groot NM,van Erven L,Bootsma M,van der Wall EE,Schalij MJ

doi

10.1046/j.1540-8167.2002.00417.x

keywords:

subject

Has Abstract

pub_date

2002-05-01 00:00:00

pages

417-23

issue

5

eissn

1045-3873

issn

1540-8167

journal_volume

13

pub_type

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