Combined approach improves the outcomes of catheter ablation of idiopathic ventricular arrhythmias originating from the vicinity of tricuspid annulus.
BACKGROUND
Ablation of idiopathic ventricular arrhythmias (VAs) originating from the vicinity of tricuspid annulus (TA) is often unsuccessful via inferior approach. We report the initial experience with catheter ablation of VAs arising from the vicinity of the TA via superior approach.


METHODS
We retrospectively studied 36 patients with VAs arising from the vicinity of TA who underwent ablation via transfemoral vein approach first. If patients had a failed prior ablation or VAs recurred during follow-up, they were referred for repeat ablation via transsubclavian vein approach.


RESULTS
Among 36 patients, 11 (30.6%) patients (five failed during the index procedure and six recurred during the follow-up) were assigned to perform repeat ablation via the transsubclavian vein approach. After the final procedure two patients recurred again, and success rate increased from 69.5% (25/36) to 94.4% (34/36). Amplitudes of the atrial electrograms of all successful ablation sites via the transsubclavian vein approach was <0.036 mV.


CONCLUSIONS
The transsubclavian vein approach plus transfemoral vein approach improve the outcomes of catheter ablation of idiopathic VAs originating from the vicinity of TA. The transsubclavian vein approach is a feasible alternative for VAs, which has been refractory to ablation via the inferior approach.
Cardiovascular Department, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangzhou, China; Department of Cardiology, Affiliated hospital of Guangdong Medical College, Zhanjiang, China.
Teng
T
Li
Xian-Zhang
XZ
Zhan
Yu-Mei
YM
Xue
Xian-Hong
XH
Fang
Hong-Tao
HT
Liao
Hai
H
Deng
Wei
W
Wei
Shu-Lin
SL
Wu
D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000601:surgery*; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery*; D018879:Ventricular Premature Complexes / Q000175:diagnosis* / Q000601:surgery*; D055815:Young Adult
catheter ablation; premature ventricular contractions; ventricular arrhythmias; ventricular tachycardia