title: [Catheter ablation of ventricular outflow tract arrhythmias using an electroanatomic mapping system].
abstract: BACKGROUND
  In some patients with arrhythmias originating from the ventricular outflow tract, catheter ablation may be considered for curative treatment. The conventional ablation procedure may be limited particularly in cases with nonsustained arrhythmias. Only little information is available about three-dimensional electroanatomic mapping combined with the cooled radiofrequency (RF) catheter ablation technique in the treatment of such arrhythmias.
  
  
  METHODS
  17 symptomatic and drug-refractory patients were included into this study. Using an electroanatomic mapping system (CARTO), activation mapping was obtained in twelve patients during ventricular tachycardia (VT) or ventricular ectopic beats. In five cases with nonsustained arrhythmias pace mapping during sinus rhythm was performed. The aim was to identify the precise localization of the arrhythmia origin and to abolish its activity by cooled ablation.
  
  
  RESULTS
  Procedure time was 117 +/- 35 min, fluoroscopy time totaled 17 +/- 13 min. Ablation was performed with a mean of 7 +/- 5 ablation pulses. In 15 patients (88%) ablation of the clinical VT was acutely successful. During a follow-up of 9 +/- 9 months, two patients had a recurrence of the clinical VT. In one of these cases a successful reablation was performed. No major complications were observed.
  
  
  CONCLUSIONS
  Electroanatomic mapping combined with focal cooled ablation strategy is a safe method to treat ventricular outflow tract arrhythmias effectively.
authors.affiliation: HELIOS Klinikum Wuppertal, Universitätsklinikum der Universität Witten/Herdecke Herzzentrum Wuppertal, Kardiologie, Arrenberger Strasse 20, 42117, Wuppertal. mhorlitz@wuppertal.helios-kliniken.de
authors.forename: Marc
authors.initials: M
authors.lastname: Horlitz
authors.forename: Philipp
authors.initials: P
authors.lastname: Schley
authors.forename: Armin
authors.initials: A
authors.lastname: Sause
authors.forename: Michael
authors.initials: M
authors.lastname: Müller
authors.forename: Dong-In
authors.initials: DI
authors.lastname: Shin
authors.forename: Rolf Michael
authors.initials: RM
authors.lastname: Klein
authors.forename: Hartmut
authors.initials: H
authors.lastname: Gülker
mesh_terms: D000328:Adult; D000368:Aged; D018780:Body Surface Potential Mapping / Q000295:instrumentation*; D005117:Cardiac Complexes, Premature / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000295:instrumentation*; D017679:Cryotherapy / Q000295:instrumentation; D004562:Electrocardiography / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*