Circulation, Vol 82, 2093-2099, Copyright © 1990 by American Heart Association
F Morady, AH Kadish, L DiCarlo, WH Kou, S Winston, M deBuitlier, H Calkins, S Rosenheck and J Sousa
Ten consecutive patients with recurrent episodes of symptomatic,
idiopathic, sustained monomorphic ventricular tachycardia (VT) originating
in the right ventricle underwent an attempt at catheter ablation of the
ventricular tachycardia. There were seven women and three men, with a mean
age of 39 +/- 14 years (+/- SD). None of the patients had any evidence of
structural heart disease. The VT had a left bundle branch block
configuration and an inferior axis in each patient, and the mean cycle
length was 313 +/- 75 msec. Based on the methods of induction of the VT and
the response of the VT to verapamil, the VT mechanism was presumed to be
reentry in six patients, triggered activity in three patients, and
catecholamine-sensitive automaticity in one patient. Sites for ablation
were guided by pace mapping, and an appropriate target site was identified
in the right ventricular outflow tract in each patient. From one to three
shocks of 100-360 J (mean total, 336 +/- 195 J) were delivered from a
defibrillator between the tip of the ablation catheter (cathode) and a
patch electrode on the anterior chest (anode). An electrophysiology test
7-9 days after ablation demonstrated that VT was still inducible in only
one patient, who was treated with amiodarone. One other patient had a
recurrence of VT 3 weeks after ablation and was treated with verapamil.
Eight of 10 patients were not treated with antiarrhythmic medications and
have had no episodes of symptomatic VT during 15-68 months of follow-up
(mean follow-up, 33 +/- 18 months). There were no acute or long-term
complications.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Long-term results of catheter ablation of idiopathic right ventricular tachycardia
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0022.
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