Stable and unstable ventricular tachycardias in patients with previous myocardial infarction: a clinically oriented strategy for catheter ablation.
OBJECTIVE
Catheter ablation of ventricular tachycardia (VT) after myocardial infarction (MI) can be complex and time-consuming. We only targeted the previously documented VTs and those with similar or longer cycle lengths.


METHODS
30 patients with VTs after MI were included in the study. Voltage mapping was performed using an electro-anatomic mapping system (CARTOT). Stable VTs were mapped during tachycardia and unstable VTs during sinus rhythm.


RESULTS
Clinical VTs were stable in 16 (53%) and unstable in 14 (47%) patients, and ablation was successful in 11 (69%) and 9 patients (64%), respectively (p = 0.42). During follow-up (14 +/- 6 months), 4 patients (25%) treated for stable and 6 (43%) for unstable VTs had recurrences (p = 0.82); ablation was successful in none and 2 (33%) of them, respectively. Non-target VTs were inducible in 11 (55%) of 20 patients after successful ablation and non-inducible in 9 (45%). During follow-up, inducibility of non-target VTs did not predict recurrences (9 vs. 11%, p = 0.88).


CONCLUSIONS
Catheter ablation of VTs after MI can be successfully performed. Acute success rates seem to be similar for stable and unstable VTs. VTs faster than those documented clinically exert a minor effect on VT recurrences during follow-up.
Ventura
Rodolfo
R
Department of Cardiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. ventura@uke.uni-hamburg.de
Klemm
Hanno U
HU
Rostock
Thomas
T
Lutomsky
Boris
B
Risius
Tim
T
Steven
Daniel
D
Weiss
Christian
C
Meinertz
Thomas
T
Willems
Stephan
S
D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome