Radiofrequency catheter ablation of premature ventricular contractions originating in the right ventricular outflow tract.
OBJECTIVE
To evaluate if radiofrequency catheter ablation is an effective procedure for the treatment of right ventricular outflow tract premature ventricular contractions (RVOT-PVC) and ascertain if it results in an improvement of symptoms.


METHODS
A prospective study with 30 consecutive patients (mean age 40 +/- 13 years, 25 females), with no apparent structural cardiopathy, with very frequent (mean density of 1,263 +/- 593/h) RVOT-PVC, symptomatic for more than one year (mean = 74 months) and resistant to antiarrhythmic drugs (3 +/- 1.7, including beta-blockers), who underwent radiofrequency catheter ablation.


RESULTS
After the first procedure, there were 23 initial successful cases (76.6%) and 7 initial failures (23.4%). Four patients experienced relapses, two of whom did not undergo the second procedure. The second procedure was carried out in 9 patients (7 initial failures and 2 relapses), and there was success in 5 additional patients, one of them by epicardial access. The final success rate was 80% (24/30), and there were no major complications. After a mean follow-up of 14 +/- 6 months, in the successful group there was a reduction greater than 90% in density of premature ventricular contractions (PVC) (24/24; p<0.0001) and a resulting absence of symptoms in the majority of patients (23/24; p<0.001).


CONCLUSIONS
Radiofrequency catheter ablation is a safe and effective treatment for patients with persistent and symptomatic PVC with RVOT morphology.
Darrieux
Francisco C C
FC
Instituto do Coração, Hospital das Clínicas, FM, USP, São Paulo, SP, Brazil. francisco.darrieux@incor.usp.br
Scanavacca
Maurício I
MI
Hachul
Denise T
DT
Melo
Sissy L
SL
D'Avilla
André B
AB
Gruppi
César J
CJ
Moffa
Paulo J
PJ
Sosa
Eduardo A
EA
D000328:Adult; D017115:Catheter Ablation / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000150:complications / Q000601:surgery*; D018879:Ventricular Premature Complexes / Q000150:complications / Q000601:surgery*