title: Radiofrequency ablation versus antiarrhythmic medication for treatment of ventricular premature beats from the right ventricular outflow tract: prospective randomized study.
abstract: BACKGROUND
  The purpose of this study was to compare the efficacy of radiofrequency catheter ablation (RFCA) versus antiarrhythmic drugs (AADs) for treatment of patients with frequent ventricular premature beats (VPBs) originating from the right ventricular outflow tract (RVOT).
  
  
  RESULTS
  A total of 330 eligible patients were included in the study and were randomly assigned to RFCA or AADs group. The absolute number and the burden of VPBs on 12-lead Holter monitors were measured at baseline and at 1st, 3rd, 6th, and 12th months after randomization. Left ventricular eject fraction was evaluated by transthoracic echocardiogram at baseline and at 3 and 6 months after randomization. During the 1-year follow-up period, VPB recurrence was significantly lower in patients randomized to RFCA group (32 patients, 19.4%) versus AADs group (146 patients, 88.6%; P<0.001, log-rank test). In a Poisson generalized estimating equations (GEE) regression model, RFCA was associated with a greater decrease in the burden of VPBs (incidence rate ratio 0.105; 95% confidence intervals [0.104-0.105]; P<0.001) compared with AADs. In a liner GEE model, the left ventricular eject fraction had a tendency to increase after the treatment in both groups (coefficient, 0.584; 95% confidence intervals [0.467-0.702]; P<0.001). In a Cox proportional model, the QS morphology in lead I was the only predictor of VPB recurrence free for catheter ablation (hazards ratio, 0.154; 95% confidence intervals [0.044-0.543]; P=0.004).
  
  
  CONCLUSIONS
  Catheter ablation is more efficacious than AADs for preventing VPB recurrence in patients with frequent VPBs originating from the RVOT. QS morphology in lead I was associated with better outcome after ablation.
authors: Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, China.
authors: Zhiyu
authors: Z
authors: Ling
authors: Zengzhang
authors: Z
authors: Liu
authors: Li
authors: L
authors: Su
authors: Vadim
authors: V
authors: Zipunnikov
authors: Jinjin
authors: J
authors: Wu
authors: Huaan
authors: H
authors: Du
authors: Kamsang
authors: K
authors: Woo
authors: Shaojie
authors: S
authors: Chen
authors: Bin
authors: B
authors: Zhong
authors: Xianbin
authors: X
authors: Lan
authors: Jinqi
authors: J
authors: Fan
authors: Yanping
authors: Y
authors: Xu
authors: Weijie
authors: W
authors: Chen
authors: Yuehui
authors: Y
authors: Yin
authors: Saman
authors: S
authors: Nazarian
authors: Bernhard
authors: B
authors: Zrenner
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055502:Secondary Prevention; D013318:Stroke Volume; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: anti-arrhythmia agents; catheter ablation