Long-term follow-up of idiopathic ventricular fibrillation ablation: a multicenter study.
OBJECTIVE
This multicenter study sought to evaluate the long-term follow-up of patients ablated for idiopathic ventricular fibrillation (VF).


BACKGROUND
Catheter ablation of idiopathic VF that targets ventricular premature beat (VPB) triggers has been shown to prevent VF recurrences on short-term follow-up.


METHODS
From January 2000, 38 consecutive patients from 6 different centers underwent ablation of primary idiopathic VF initiated by short coupled VPB. All patients had experienced at least 1 documented VF, with 87% having experienced > or =2 VF episodes in the preceding year. Catheter ablation was guided by activation mapping of VPBs or pace mapping during sinus rhythm.


RESULTS
There were 38 patients (21 men) age 42 +/- 13 years, refractory to a median of 2 antiarrhythmic drugs. Triggering VPBs originated from the right (n = 16), the left (n = 14), or both (n = 3) Purkinje systems and from the myocardium (n = 5). During a median post-procedural follow-up of 63 months, 7 (18%) of 38 patients experienced VF recurrence at a median of 4 months. Five of these 7 patients underwent repeat ablation without VF recurrence. Survival free of VF was predicted only by transient bundle-branch block in the originating ventricle during the electrophysiological study (p < 0.0001). The number of significant events (confirmed VF or aborted sudden death) was reduced from 4 (interquartile range 3 to 9) before to 0 (interquartile range 0 to 4) after ablation (p = 0.01).


CONCLUSIONS
Ablation for idiopathic VF that targets short coupled VPB triggers is associated with a long-term freedom from VF recurrence.
Knecht
Sébastien
S
Hôpital Cardiologique du Haut-Lévêque and the Université Victor Segalen Bordeaux II, Bordeaux, France. sebastien.knecht@chu-brugmann.be
Sacher
Frédéric
F
Wright
Matthew
M
Hocini
Mélèze
M
Nogami
Akihiko
A
Arentz
Thomas
T
Petit
Bertrand
B
Franck
Robert
R
De Chillou
Christian
C
Lamaison
Dominique
D
Farré
Jéronimo
J
Lavergne
Thomas
T
Verbeet
Thierry
T
Nault
Isabelle
I
Matsuo
Seiichiro
S
Leroux
Lionel
L
Weerasooriya
Rukshen
R
Cauchemez
Bruno
B
Lellouche
Nicolas
N
Derval
Nicolas
N
Narayan
Sanjiv M
SM
Jaïs
Pierre
P
Clementy
Jacques
J
Haïssaguerre
Michel
M
D000328:Adult; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016019:Survival Analysis; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000628:therapy*