[Treatment of ventricular tachycardia by endocardial fulguration. Apropos of 86 cases]

Between 1983 and 1991, 86 cases of ventricular tachycardia (VT) resistant to antiarrhythmic therapy were treated by endocardious catheter fulguration: there were 21 cases of right ventricular dysplasia (RVD), 35 chronic myocardial infarctions (MI), 11 dilated cardiomyopathies (DCM), 10 bundle branch VT, 5 idiopathic septal VT, 3 operated Fallot procedures, 1 Ebstein's anomaly. There were 69 men and 17 women aged 14 to 76 years (average 45 +/- 18 years). The ejection fraction was under 30% in 37 cases. Forty-five VTs were permanent or recurred several times daily; 6 were inducible despite drug therapy and 35 patients had monthly recurrences. A total of 141 different forms of VT were treated in 133 procedures. One session was sufficient in 49 cases; 2 sessions were required in 29 cases; 3 sessions in 6 cases and 4 sessions in 2 cases. A total of 480 DC shocks were delivered with energies of 160 to 300 joules. The CPK-MB levels were 37 +/- 30 i.u./l. The following complications were observed: 7 perioperative deaths, 2 cardiac tamponades requiring surgical drainage, 1 permanent AV block, 5 reversible left ventricular failures. Follow up concerned 79 patients: 5 were followed up for less than 3 months with death occurring from cardiac failure which had been present before the ablation procedure without recurrence of VT. Seventy-four patients were followed up from 3 to 111 months (56 +/- 33 months). Thirty-two patients were without any antiarrhythmic therapy and had no recurrence of VT. Two of these patients developed a different form of VT 2 and 6 years after the catheter ablation.(ABSTRACT TRUNCATED AT 250 WORDS)