Radiofrequency ablation of ventricular tachycardia in post myocardial infarction patients: Kuwait experience

ABSTRACT

We evaluated prospectively 5 patients with previous myocardial infarction who had ventricular tachycardia. The objective of this study was to describe the arrhythmogenic areas and ablate the ischemic VT successfully with multiple radiofrequency applications. All patients were considered eligible irrespective of the presence of Automatic implantable cardioverter-defibrillator implants. Coronary artery bypass graft was performed for two patients. One patient had developed ventricular tachycardia/ventricular fibrillation post surgery requiring radiofrequency ablation followed by AICO implantation. Three patients with ischemic cardiomyopathy, who had AICO, developed VT prior to the radio frequency ablation therapy. In 5 patients with ventricular tachyarrhythmias three dimensional mapping was performed using non contact mapping [EnSite]. RF ablations targeted the arrhythmogenic areas of infarcted zone. All patients were rendered completely non inducible at the end of the procedure. The mean procedure time measured was 3 hours. No complications were observed in any of those patients. On follow up, all patients improved clinically with regard to the quality of life and number of AICD shocks. One post AICD patient had non sustained ventricular tachycardia, during the follow up period. This is a limited study of our local experience in the successful radio frequency ablation of ischemic ventricular tachycardia