[Radiofrequency catheter ablation of symptomatic isolated ventricular extrasystole in patients with a normal heart].
BACKGROUND
Premature ventricular depolarizations (PVDs) in patients without heart disease, are a frequent clinical problem that can cause important symptoms. Most commonly, this benign arrhythmia responds to treatment with antiarrhythmic drugs. However, occasionally PVDs are refractory to pharmacological treatment but they can be eliminated with radiofrequency catheter ablation.


OBJECTIVE
To show our experience with four patients in whom we used this method.


METHODS
We studied three men and a woman, twelve to forty six years old. All of them were symptomatic, their EKG and echocardiogram were normal and they had been treated with several drugs without response. In three of them the PVDs had left bundle-branch block morphology with inferior axis; the other patient had right bundle-branch block morphology with superior axis. The origin of the PVDs was determined using pace mapping.


RESULTS
Two of the patients had spontaneous PVDs; in the other two isoproterenol infusion was used to induce them. In three patients the origin of the PVDs was located in right ventricular outflow and in the other in the anterolateral region of the left ventricle. None had sustained atrial or ventricular arrhythmia. In all of them PVDs were eliminated. A patient presented a second morphology that could not be treated. None of the patients had complications and they were discharged within the next 24 hours. Three noted symptomatic improvement and after 18 months, only one had a probable recurrence of the arrhythmia.


CONCLUSIONS
Radiofrequency catheter ablation can be successfully used to eliminate PVDs in severely symptomatic and drug-resistant patients.
Laboratorio de Electrofisiología Cardíaca, Departamento de Enfermedades Cardiovasculares, Pontificia Universidad Católica de Chile. Marcoleta 357, Santiago, Chile.
M
M
Seguel
E
E
Schumacher
R
R
González
D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D002648:Child; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018879:Ventricular Premature Complexes / Q000601:surgery*