Premium
Long‐Term Clinical Outcome of Right Bundle Branch Radiofrequency Catheter Ablation for Treatment of Bundle Branch Reentrant Ventricular Tachycardia
Author(s) -
MEHDIRAD ALI AKBAR,
KEIM STEPHEN,
RIST KEVIN,
TCHOU PATRICK
Publication year - 1995
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1995.tb04638.x
Subject(s) - medicine , cardiology , right bundle branch block , ventricular tachycardia , tachycardia , left bundle branch block , ablation , catheter ablation , ejection fraction , electrophysiology study , heart transplantation , bundle branch block , bundle branches , electrocardiography , heart failure , electrical conduction system of the heart
This study assessed the long‐term outcome of patients undergoing radiofrequency ablation of the right bundle for bundle branch reentrant ventricular tachycardia. Bundle branch reentrant tachycardia was diagnosed in 16 patients (ejection fraction 31%± 15%) who underwent electrophysiology study in our laboratory. All patients had His‐Purkinje system conduction delay with mean HV interval of 68 ± 8 ms. After ablation, right bundle branch block developed in 15 patients. One patient developed complete heart block, which was anticipated. One patient died of heart failure 9 months after ablation. Two patients were successfully bridged to heart transplantation 0.5 and 13 months, respectively, after ablation. Two patients received implantable defibrillators for other ventricular tachycardias. One patient had syncope 11 months after ablation, but there was no evidence of ventricular tachycardia or heart block in repeat electrophysiology study. This patient died suddenly 29 months after ablation. The remaining nine patients were alive and well for a mean follow‐up of 19 ± 10 months. Radiofrequency ablation of the right bundle branch is an effective therapy for treatment of bundle branch reentrant ventricular tachycardia. Survival is excellent provided that other types of ventricular tachycardia, when present, are treated as well. This technique maybe helpful in management of patients who have unacceptable frequent shocks from their implanted defibrillators and may be helpful in avoiding implantation of such a device completely in others. In some patients with terminal heart failure and incessant ventricular tachycardia, this procedure can function as a bridge to cardiac transplantation.