Radiofrequency Catheter Ablation of Ventricular Tachycardia in Patients without Structural Heart Disease

ABSTRACT

BACKGROUND: Radiofrequency catheter ablation therapy of idiopathic ventricular tachycardia in patients without obvious structural heart disease has been assessed in a few studies, but the clinical feasibility and efficacy are not certain. This study reports our results of catheter ablation with radiofrequency energy in thirteen patients. METHODS: Thirteen consecutive patients with idiopathic ventricular tachycardia underwent electrophysiologic study, pharmacological interventions and radiofrequency catheter ablation therapy. RESULTS: There were 7 men and 6 women with a mean age of 34+/-11years(13-55 years). The QRS configuration during tachycardia were left bundle branch block and inferior axis in 5 patients, right axis in 1 patient and right bundle branch block configuration with superior axis in 4 patients, right axis in 2 patients, left axis in 1 patients. Mean tachycardia cycle length was 361 +/-20 milliseconds. The focus of ventricular tachycardia were located in the right ventricular outflow tract(six patients) and the left ventricular inferior wall(four patients), posterobasal wall(one patients), anterolateral wall(one patients). Ventricular tachycardias were electrically induced in 9/13 patients. Mapping and radiofrequent catheter ablation was done with standard technique and ventricular tachycardia or VPCs were successfully eliminated in nine patients(69.2%). One patients complicated with transient pleural effusion. During mean follow-up period of 12+/-3months, one patients had a recurrence of symptomatic ventricular tachycardia. CONCLUSION: Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease is effective and safe and may be considered as primary choice of therapy in the patients.