Clinical evaluation of catheter ablation for idiopathic ventricular arrhythmia originating from ventricular outflow tract
Department of cardiology, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China. Zhonghua yi xue za zhi
To study the ECG and electrophysiological characteristic of idiopathic ventricular tachycardia (VT) and premature ventricular contraction (PVC) originating from ventricular outflow tract and assess the clinical effect of radiofrequency catheter ablation (RFCA) for treatment.
105 patients aged from 12 to 73 years old were treated with RFCA. Activation mapping, pace mapping and non-contact mapping system of Ensite 3000 were used during the procedure.
(1) VT and PVC were successfully ablated in 97 out of the 105 patients (93.3%), 15 were recurrent but succeed in the second time. (2) 84 patients originated from right ventricle outflow tract (RVOT) and the remaining 21 patients from left ventricle outflow tract (LVOT). (3) 3 patients have the pericardial tamponade during ablation.
RFCA is an effective and curative therapy for ventricular arrhythmia originating from ventricular outflow tract.
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ABSTRACT: Radiofrequency catheter ablation (RFCA) has been established as an effective and curative therapy for ventricular tachycardia (VT) and severely symptomatic premature ventricular contraction (PVC) from the outflow tract in structurally normal hearts. This study aimed to investigate electrophysiologic characteristics and effects of RFCA for patients with idiopathic VT and symptomatic PVC originating from the valve annulus.
Characteristics of body surface electrocardiogram (ECG) and endocardiogram in a successful RFCA target were analyzed in 16 patients with idiopathic VT and symptomatic PVC originating from the valve annulus. Additionally, the ECG characteristics of VT or PVC were compared with those of manifest Wolff-Parkinson-White (WPW) syndrome originating from the same site of origin in 15 patients.
Thirteen patients were successful, 2 recurrent and 1 failed. The recurrent cases underwent successful ablation the second time guided by the Ensite 3000 mapping system. In all patients with the WPW syndrome, the characteristics of QRS morphology were well matched with those of the VT and PVC that originated from corresponding sites of origin.
RFCA is an effective curative therapy for VT and symptomatic PVC originating from the valve annulus. There are specific characteristics in ECG and the ablation site could be located by means of the WPW syndrome accessory pathway's algorithm.
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ABSTRACT: To determine the outcome of Radiofrequency Catheter Ablation (RFCA) as a non-pharmacological curative therapy for idiopathic Ventricular Tachycardia (VT) and to identify procedure-related complications.
The Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, from February 2001 to October 2008.
Ninety eight consecutive patients with idiopathic VT, resistant to drug therapy, who underwent Electrophysiology Studies (EPS) radiofrequency catheter ablation were enrolled. Clinical and electrophysiological variables were recorded and a descriptive analysis was done.
Out of the 98 patients, 79 were males (80.6%). The mean age was 33.29+11.93 years. Modes of presentation were sustained VT, Repetitive Monomorphic VT (RMVT), Non-sustained VT (NSVT) and Ventricular Premature Beats (VPBs). Right Ventricular Outflow Tract (RVOT) VT was found in 37 patients, 37 had Idiopathic Left Ventricular Tachycardia (ILVT), 20 had Left Ventricular Outflow Tract (LVOT) VT, and Inflow Right Ventricular Tachycardia (IRVT) was found in 7 patients. Other sites of origin of VT were infrequent. Eight patients had dual morphologies of VT. Atrioventricular Nodal Re-entry Tachycardia (AVNRT) was found in 8 patients. RFCA was successful in abolishing inducible VT in 88 patients. One patient developed complete AV block requiring a permanent pacemaker.
Results of this study confirm a high degree of success and safety of radiofrequency catheter ablation as curative therapy for idiopathic ventricular tachycardia.
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