Radiofrequency ablation of the ventricular tachycardia with arrhythmogenic right ventricular cardiomyopathy using non-contact mapping.
BACKGROUND
Intracardiac non-contact mapping provides a rapid and accurate isopotential mapping that facilitates catheter ablation of the ventricular tachyarrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC).


METHODS
Thirty-two consecutive patients (26 men and 6 women, mean 37.2 +/- 13.8 years) were treated with ablation. Fourteen patients had a history of syncope/pre-syncope. Two patients had an implantable cardiac defibrillator (ICD) previously implanted.


RESULTS
There were 67 ventricular tachycardias (VTs) induced in the 32 patients. The average VT rate was 210 +/- 32.2 (130-310) bpm. There were 42 episodes of VT that had a heart rate > or =200 bpm and 24 of the 32 patients (75%) had > or =2 morphologies of VT. Regional ablation was applied by targeting the earliest VT activation sites under the guidance of non-contact mapping. Acute success was achieved in 84.4% (27/32) patients, and significant improvement was seen in 15.6% (5/32) patients as evidenced by a slower rate of VT. None of the patients experienced syncope/pre-syncope or sudden death during the 28.6 +/- 16 (9-72) month follow-up. There were no complications of the procedure. At the end of follow-up, 81.3% of the patients were free of VT without medication while the rest of the patients achieved a modified success.


CONCLUSIONS
The rapid ventricular tachyarrhythmias in ARVC patients can be abolished or improved significantly by regional RF catheter ablation under the guidance of non-contact mapping. There was no sudden cardiac arrest or death in those patients without ICD implantation. Delayed efficacy may occur in some patients after ablation.
Yao
Yan
Y
Clinical EP Lab and Cardiac Arrhythmia Service Center, Cardiovascular Institute, Fuwai Heart Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China. ianyao@263.net.cn
Zhang
Shu
S
He
Ding Sheng
DS
Zhang
Kuijun
K
Hua
Wei
W
Chu
Jianmin
J
Pu
Jielin
J
Chen
Keping
K
Wang
Fangzheng
F
Chen
Xin
X
D000293:Adolescent; D000328:Adult; D000368:Aged; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome