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Radiofrequency catheter ablation in recurrent ventricular tachycardia
B D Gonska1, S Brune, K P Bethge
1Department of Cardiology, University of Goettingen, Germany.
European Heart Journal
|December 1, 1991
Summary
Radiofrequency catheter ablation effectively treated recurrent ventricular tachycardia in 10 patients resistant to medication. While most patients remained free of tachycardia, long-term follow-up showed recurrence in two, highlighting its potential for high-risk individuals.
Area of Science:
- Cardiology
- Electrophysiology
- Interventional Cardiology
Background:
- Recurrent monomorphic sustained ventricular tachycardia (VT) poses a significant risk, especially when refractory to antiarrhythmic drugs.
- Identifying the precise origin of VT is crucial for effective treatment strategies.
Purpose of the Study:
- To evaluate the efficacy and safety of radiofrequency catheter ablation for drug-resistant ventricular tachycardia.
- To determine the feasibility of ablating VT originating from various left ventricular locations.
Main Methods:
- Ten patients with refractory VT underwent electrophysiological studies, including activation and pace-mapping, to localize the tachycardia origin.
- Transcatheter radiofrequency ablation was performed using bipolar or quadripolar catheters.
- Patients were monitored for tachycardia inducibility and recurrence post-ablation.
Main Results:
- VT origin was consistently localized to the left ventricle (septum, posterolateral, or anterobasal wall).
- All patients achieved acute success, with no inducible clinical tachycardia post-ablation.
- During 22–32 months follow-up, two patients experienced VT recurrence, and one had sudden cardiac death; others remained asymptomatic.
Conclusions:
- Radiofrequency catheter ablation is a potentially beneficial and safe therapeutic option for carefully selected patients with drug-resistant ventricular tachycardia.
- The procedure demonstrated acute efficacy in eliminating inducible VT, with a favorable long-term outcome in the majority of high-risk patients.