Radiofrequency catheter ablation in recurrent ventricular tachycardia

Abstract

Catheter ablation by radiofrequency energy was carried out in 10 patients with one type of recurrent monomorphic sustained ventricular tachycardia resistant to medical antiarrhythmic management. Electrophysiological studies before ablation included activation and pace-mapping. In all patients, the origin of the tachycardia was localized in the left ventricle: in the septum in six, at the posterolateral wall in three and anterobasal in one. The earliest onset of endocardia! activation preceding the QRS complex during ventricular tachycardia ranged between-45 and-90 ms. Transcatheter ablation was performed with a bipolar or quadripolar catheter using a radiofrequency generator (HA T100, Osypka). No complications occurred during the ablation procedure. Thereafter, in all patients, the clinical tachycardia was no longer inducible by programmed stimulation. During a follow-up period of 22 to 32 months including eight patients, the tachycardia recurred in two; one of these patients subsequently died suddenly. A third patient had one episode of a new type of sustained ventricular tachycardia some hours after catheter ablation. In the remaining patients, there was no recurrence of symptomatic tachycardia under maintainance of the antiarrhythmic management which, prior to ablation had been ineffective. Thus, our preliminary results suggest that radiofrequency catheter ablation might be beneficial for these high risk patients.

Characteristics and identification of sites of chagasic ventricular tachycardia by endocardial mapping

“…In patients with sustained ventricular tachycardia (SVT) of ischemic etiology, encouraging success rates, varying from 42 to 75% [5][6][7][8][9][10][11][12] , have been achieved, leading to increasing scientific interest in improving this technique. This procedure requires detailed knowledge of the arrhythmogenic substrate because the lesion produced by RF energy is localized and a precise identification of the site of origin of the tachycardia is necessary.…”

Innovations in Clinical Cardiac Electrophysiology: Challenges and Upcoming Solutions in 2018 and Beyond

“…41 The success of RF energy application lead to its use in treating atrial flutter, 42 AF, [43][44][45] and ventricular arrhythmias. 46,47 To this day, it is the most commonly used energy source.…”

Effect of Inter‐electrode Distance on Bipolar Intramural Radiofrequency Ablation

“…Despite encouraging treatments for supraventricular tachycardia, success has been particularly disappointing in patients with ventricular tachycardia and coronary artery disease 1–6 . The standard techniques using 4 mm monopolar catheters are capable of eliminating foci adjacent to the endocardium, however, novel approaches may be necessary in deep intramural or epicardial foci of re‐entry.…”