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Radiofrequency Ablation of the Ventricular Tachycardia with Arrhythmogenic Right Ventricular Cardiomyopathy Using Non‐contact Mapping

2007; Wiley; Volume: 30; Issue: 4 Linguagem: Inglês

10.1111/j.1540-8159.2007.00703.x

1540-8159

Yan Yao, Shu Zhang, Ding Sheng He, Kuijun Zhang, Wei Hua, Jianmin Chu, Jielin Pu, Keping Chen, Fangzheng Wang, Xin Chen,

Cardiac electrophysiology and arrhythmias

Background: Intracardiac non‐contact mapping provides a rapid and accurate isopotential mapping that facilitates catheter ablation of the ventricular tachyarrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods: Thirty‐two consecutive patients (26 men and 6 women, mean 37.2 ± 13.8 years) were treated with ablation. Fourteen patients had a history of syncope/pre‐syncope. Two patients had an implantable cardiac defibrillator (ICD) previously implanted. Results: There were 67 ventricular tachycardias (VTs) induced in the 32 patients. The average VT rate was 210 ± 32.2 (130–310) bpm. There were 42 episodes of VT that had a heart rate ≥200 bpm and 24 of the 32 patients (75%) had ≥2 morphologies of VT. Regional ablation was applied by targeting the earliest VT activation sites under the guidance of non‐contact mapping. Acute success was achieved in 84.4% (27/32) patients, and significant improvement was seen in 15.6% (5/32) patients as evidenced by a slower rate of VT. None of the patients experienced syncope/pre‐syncope or sudden death during the 28.6 ± 16 (9–72) month follow‐up. There were no complications of the procedure. At the end of follow‐up, 81.3% of the patients were free of VT without medication while the rest of the patients achieved a modified success. Conclusions: The rapid ventricular tachyarrhythmias in ARVC patients can be abolished or improved significantly by regional RF catheter ablation under the guidance of non‐contact mapping. There was no sudden cardiac arrest or death in those patients without ICD implantation. Delayed efficacy may occur in some patients after ablation.