[Comparative study of results of catheter ablation in ventricular tachycardia of different etiologies].
BACKGROUND
The aim of this study was to assess long-term results and adverse events in patients with ventricular tachycardia from different etiologies.


METHODS
The recurrence rate of tachycardia, consequent further therapies (other catheter ablation procedures, drug therapy and implantable defibrillator) and clinical events have been assessed in 60 consecutive patients undergoing ventricular tachycardia catheter ablation between January 2000 and December 2004.


RESULTS
During a median follow-up of 20 months (interquartile range 13-36 months), tachycardia recurred in 27 patients (45%) after a median of 3 months (interquartile range 1-12 months). A second procedure was performed in 11 patients; it was successful in 8 patients. Four patients underwent pharmacological therapy which was successful in all cases. Overall, after ablation (> or =1 procedures) and pharmacological therapy, tachycardia was cured in 75% of cases. All the 20 patients without structural heart disease were cured with ablation vs. 62% of patients with heart disease (p = 0.001). Patients with dilated cardiomyopathy reported worst results (33% success, p = 0.03). Recurrences were predicted by acute failure of procedure (p = 0.05), presence of heart disease (p = 0.006) and history of atrial arrhythmias (p = 0.02). On a multivariate analysis, only structural heart disease continued to be an independent predictor of ventricular tachycardia recurrence.


CONCLUSIONS
Catheter ablation of ventricular tachycardia has a high percentage of recurrences in patients with heart disease, whereas is curative in subjects without structural heart disease.
Maggi
Roberto
R
Dipartimento di Cardiologia, Ospedali del Tigullio Via Don Bobbio, 25 16033 Lavagna. rmaggi@asl4.liguria.it
Quartieri
Fabio
F
Donateo
Paolo
P
Bottoni
Nicola
N
Solano
Alberto
A
Lolli
Gino
G
Tomasi
Corrado
C
Croci
Francesco
F
Oddone
Daniele
D
Puggioni
Enrico
E
Menozzi
Carlo
C
Brignole
Michele
M
D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D018570:Risk Assessment; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome