Radiofrequency current catheter ablation for ventricular tachycardia
Related Experiment Videos
M Chinushi1, Y Aizawa, Y Kusano
1First Department of Internal Medicine, Niigata University School of Medicine, Japan.
Unlabelled:
Radiofrequency current catheter ablation was attempted for 17 morphologies of ventricular tachycardia (VT) in 14 patients. Five patients had underlying heart disease. The site of VT origin was determined as the earliest site of ventricular activation, or by pacing within the area of slow conduction. In 15 VTs, ablation was performed during VT, and 12 VTs (80%) were terminated within an average of 5.4 +/- 4.2 seconds. After ablation, 14 VTs (14/17 = 82%) of 11 patients (11/14 = 79%) could not be induced by electrical stimulation. Radiofrequency ablation appeared to be more effective in VTs without underlying heart disease (91%), and in VTs originating from the right ventricle (100%). Successful ablation sites usually showed a normal local electrograms during VT. Ablation in the slow conduction area was attempted in 3 VTs, and 2 VTs became noninducible. The mean number of applications of radiofrequency current for each VT origin was 7.7 +/- 6.4 at 20-50 Watts. In 4 patients, application of radiofrequency current was required 10 or more times because of a possible large arrhythmogenic area, or because of reinduction of VT, even though VT was terminated by radiofrequency current. No major complication was observed except for complete right bundle branch block in 1 patient.
In Conclusion:
(1) Radiofrequency catheter ablation was considered to be effective and safe, especially for VT without underlying heart disease or VT originating from the right ventricle. (2) Ablation during VT was considered to be useful for identifying the proper ablation site and to avoid creating an unnecessary lesion.
Insights
Radiofrequency catheter ablation effectively treated ventricular tachycardia (VT), particularly in patients without heart disease or with right ventricular VT. Ablation during VT improved site identification and safety, proving effective and safe overall.
Area of Science:
- Cardiovascular Electrophysiology
- Interventional Cardiology
- Cardiac Arrhythmias
Background:
- Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia.
- Catheter ablation is an established treatment for refractory VT.
- Identifying the precise origin of VT is crucial for successful ablation.
Purpose of the Study:
- To evaluate the efficacy and safety of radiofrequency current catheter ablation for various morphologies of ventricular tachycardia.
- To assess the effectiveness of ablation performed during an episode of VT.
- To determine factors influencing ablation success, such as underlying heart disease and origin of VT.
Main Methods:
- Radiofrequency catheter ablation was performed in 14 patients with 17 morphologies of VT.
- VT origin was identified by earliest ventricular activation or pacing in slow conduction areas.
- Ablation was conducted during VT in 15 cases, with energy delivered at 20-50 Watts.
Main Results:
- Eighty-two percent of treated VTs (14/17) were non-inducible post-ablation.
- Seventy-nine percent of patients (11/14) were free from inducible VT after ablation.
- Ablation was highly effective for VT without underlying heart disease (91%) and right ventricular VT (100%).
Conclusions:
- Radiofrequency catheter ablation is an effective and safe treatment for ventricular tachycardia.
- Ablation is particularly successful in VTs without underlying heart disease or originating from the right ventricle.
- Performing ablation during VT aids in accurate site identification and lesion creation, enhancing safety and efficacy.