Long-Term Follow-Up of Catheter Ablation of Ventricular Arrhythmias: Experiences from a Tertiary Referral Center in Taiwan.
BACKGROUND
Radiofrequency catheter ablation (RFCA) is an alternative therapeutic management for drug-refractory ventricular arrhythmias (VA). However, long-term follow-up of clinical outcome after RFCA for VAs in Taiwan remains unknown.


METHODS
From 1999 to 2013, patients undergoing RFCA for VAs from a single referral center were consecutively enrolled. The annual distribution of cases, clinical characteristics, etiology, disease entity and electrophysiological studies were investigated. The clinical outcomes and recurrences between distinct entities were compared.


RESULTS
A total of 502 patients receiving RFCA of VAs were eligible, including 388 patients for idiopathic VAs and 114 for substrate VAs. The annual distribution displayed a tendency towards a gradual increase in ablation cases within 2009-2013 compared with the prior decade (p < 0.001). Acute success was achieved in 453 patients (90.2%), partial success in 3 (0.6%), and failed ablation in 46 (9.2%). During a mean follow-up of 39.77 ± 48.75 months, 126 (25.1%) patients developed recurrences. Kaplan-Meier analysis demonstrated better prognosis after RFCA in patients with idiopathic fascicular VT and RVOT VAs (p < 0.001) and attenuation of the occurrences of sustained VT/VF, ICD therapies, and mortality in patients with BrS and ARVD/C (p = 0.036), as well as overall ICD interventions in substrate VAs (p < 0.001).


CONCLUSIONS
RFCA could be an effective and alternative strategy in the elimination of idiopathic VAs and prevention of malignant events in substrate VAs at an experienced referral center in Taiwan. Distinct location of arrhythmogenic trigger and disease entities may result in non-uniform recurrences and prognosis.


BACKGROUND
Idiopathic; Radiofrequency catheter ablation; Recurrence; Substrate; Ventricular arrhythmias.
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital;
Fa-Po
FP
Chung
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University;
Yenn-Jiang
YJ
Lin
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University;
Shih-Lin
SL
Chang
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University;
Li-Wei
LW
Lo
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University;
Yu-Feng
YF
Hu
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital; ; Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University, Taipei, Taiwan.
Yun-Yu
YY
Chen
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University;
Chuen-Wang
CW
Chiou
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital; ; Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University;
Shih-Ann
SA
Chen