title: Long-term results of catheter ablation for idiopathic ventricular tachycardia originated from the right ventricular outflow.
abstract: We performed catheter ablation in 10 consecutive patients with idiopathic monomorphic right ventricular tachycardia and studied the long-term outcome. All ventricular tachycardias had a left bundle branch block configuration with an inferior axis, and originated from right ventricular outflow. Antiarrhythmic drugs (3-6 drugs) had been ineffective in controlling ventricular tachycardia. The 2 patients who underwent direct-current ablation (2 shocks of 150 J) had no recurrence of ventricular tachycardia and did not require antiarrhythmic drugs during a follow-up of 56 and 51 months, respectively. Of the 8 patients who underwent radiofrequency ablation (30-40 watt, 20-40 sec, 2-15 application, using Inter Nova RA 50, 13.56 MHz), 1 patient had no recurrence of ventricular tachycardias and did not require antiarrhythmic drugs, 4 patients had no recurrence of ventricular tachycardias but did require anti-arrhythmic drugs, and 3 patients experienced recurrence of non-sustained ventricular tachycardia despite the use of antiarrhythmic drugs during a follow-up of 15-40 months. There were no complications except for cardiac perforation which occurred immediately after direct-current ablation in 1 patient. In conclusion, long-term success in preventing ventricular tachycardia was achievable with direct-current ablation, but this success was associated with serious risks, such as cardiac perforation. Radiofrequency ablation was safer than direct-current ablation, but had a lower long-term success rate.
authors.affiliation: First Department of Internal Medicine, Hiroshima University School of Medicine, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Mukai
authors.forename: H
authors.initials: H
authors.lastname: Nakagawa
authors.forename: K
authors.initials: K
authors.lastname: Nagata
authors.forename: S
authors.initials: S
authors.lastname: Karakawa
authors.forename: W
authors.initials: W
authors.lastname: Shimizu
authors.forename: Y
authors.initials: Y
authors.lastname: Tsuchioka
authors.forename: M
authors.initials: M
authors.lastname: Okamoto
authors.forename: H
authors.initials: H
authors.lastname: Matsuura
authors.forename: G
authors.initials: G
authors.lastname: Kajiyama
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D017180:Tachycardia, Ventricular / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*
chemical_list: D000889:Anti-Arrhythmia Agents