Ablation for idiopathic ventricular arrhythmia - with and without arrhythmia-induced cardiomyopathy

We conducted a study to assess the procedural success and long-term freedom from arrhythmia in patients treated with radiofrequency ablation (RFA) for idiopathic ventricular arrhythmia (VA) with and without arrhythmia-induced cardiomyopathy (AIC).

We identified 131 patients treated with RFA for idiopathic VA in our institution; 16 of whom had AIC. Data were obtained from patient files. A questionnaire was used to assess the improvement in subjective symptoms late after RFA.

At the initial RFA, any VA was abolished in 93 patients (71%), non-targeted VA still was observed in 5 patients (4%), and the targeted VA remained present in 29 (22%). In 4 patients (3%) procedural success was undeterminable. During a median follow-up time of 8 months after latest RFA, 100 patients (76%) stayed free from recurrence. We observed no difference in procedural or long-term success between patients with and without AIC. When excluding patients with fascicular ventricular tachycardia (VT), a significantly higher proportion of patients with AIC had VA originating from the left ventricle (p = 0.027). Patients with AIC had a significant improvement of ejection fraction after RFA (p < 0.001). Totally 89 of 99 patients (90%) who returned the questionnaire reported symptomatic benefit a median of 64 months after their latest procedure.

RFA is effective for treating idiopathic VA with and without AIC, with high rates of long-term freedom from VA and symptomatic relief. We found more patients with AIC had left ventricle VA.