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Radiofrequency Catheter Ablation of Drug Refractory Symptomatic Ventricular Ectopy: Short‐ and Long‐Term Results
Author(s) -
LAURIBE PHILIPPE,
SHAH DIPEN,
JAÏS PIERRE,
TAKAHASHI ATSUSHI,
HAÏSSAGUERRE MICHEL,
CLÉMENTY JACQUES
Publication year - 1999
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.1540-8159.1999.tb00544.x
Subject(s) - medicine , cardiology , asymptomatic , ventricle , refractory (planetary science) , ablation , ventricular tachycardia , arrhythmogenic right ventricular dysplasia , catheter ablation , mexiletine , cardiomyopathy , surgery , heart failure , physics , astrobiology
We performed radiofrequency catheter ablation (RFCA) in 12 consecutive patients (17–77 years) with daily, symptomatic, monomorphic ventricular ectopy (VE) (12,096 ± 3.326 on 24‐hour Holter) resistant to antiarrhythmic drugs. Nine patients had no apparent structural heart disease, 1 patient had a mild dilated cardiomyopathy, 1 patient had a treated mitral stenosis, and 1 patient had arrhythmogenic ventricular dysplasia. VE morphology was LBBB with inferior axis in 9 patients, RBBB with inferior axis in 2 patients, RBBB with superior axis in 1 patient. None of the patients had spontaneous or inducible sustained ventricular tachycardia. The VE focus was targeted with RF energy at the earliest endocardial activation site and based on a matching 12‐lead ECG pace map. The VE focus was localized in the right outflow tract in 9 patients and on the left ventricle in 3 patients. RFCA was delivered with a standard 4‐mm tip electrode. The ablation was initially successful in 11 patients and unsuccessful in 1 patient. All successfully ablated patients were asymptomatic and discharged without antiarrhythmic drugs. During follow‐up (25 ± 8; 17–38 months), two patients had a recurrence of symptoms, which were controlled by a previously ineffective drug. At the end of follow‐up, 1,329 ± 3198 VE were observed on Holter monitoring (P < 0.001 compared with initial values). No short‐ and long‐term complications were observed. RFCA is a safe and effective method for treating drug‐resistant symptomatic monomorphic VE in carefully selected patients. A persistent benefit without complications was obtained over a 2‐year follow‐up.