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. 2018 Apr;26(4):210-216.
doi: 10.1007/s12471-018-1085-5.

Catheter ablation of symptomatic idiopathic ventricular arrhythmias : A five-year single-centre experience

A W G J Oomen  1 , L R C Dekker  2 , A Meijer  2
Affiliations

Catheter ablation of symptomatic idiopathic ventricular arrhythmias : A five-year single-centre experience

A W G J Oomen et al. Neth Heart J. 2018 Apr.

Abstract

Aims: This study was designed to gain insight into the patient characteristics, results and possible complications of ablation procedures for symptomatic idiopathic premature ventricular complexes (PVC) and idiopathic ventricular tachycardia (VT).

Methods: Data were collected from all patients who underwent radiofrequency catheter ablation for symptomatic PVCs and idiopathic VT in the Catharina Hospital between 1 January 2011 and 31 December 2015. The procedural endpoint was elimination or non-inducibility of the clinical arrhythmia. Successful sustained ablation was defined as the persistent elimination of at least 80% of the PVCs or the absence of VTs at follow-up. In case of suspected PVC-induced cardiomyopathy, the systolic left ventricular function was reassessed 3 months post procedure.

Results: Our cohort consisted of 131 patients who underwent one or more ablation procedures; 99 because of symptomatic premature ventricular complexes, 32 because of idiopathic VT. In total 147 procedures were performed. The procedural ablation success rate was 89%. Successful sustained ablation rate was 82%. Eighteen (13.2%) patients had suspected PVC-induced cardiomyopathy. In 15 of them (83%), successful sustained ablation was achieved and the left ventricular ejection fraction improved from a mean of 39% (±8.8) to 55.4% (±8.1). Most arrhythmias originated from the right ventricular outflow tract (60%) or aortic cusps (13%). Complications included three tamponades.

Conclusion: Catheter ablation therapy for idiopathic ventricular arrhythmias is very effective with a sustained success rate of 82%. In patients with PVC-induced cardiomyopathy, it leads to improvement of systolic left ventricular function. However, risk for complications is not negligible, even in experienced hands.

Keywords: Ablation; Catheter; Idiopathic; Premature; Tachycardia; Ventricular.

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Conflict of interest statement

A.W.G.J. Oomen, L.R.C. Dekker and A. Meijer declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Median PVC burden before and after 1 or more ablation procedures
Fig. 2
Fig. 2
Distribution of sites of origin
Fig. 3
Fig. 3
Distribution of sites of origin in case of left ventricular dysfunction
Fig. 4
Fig. 4
LVEF before and after one or more ablation procedures for PVCs in case of left ventricular dysfunction. Full lines show the LVEF for patients with sustained successful ablation (SSA), dashed lines show the LVEF for patients without SSA
See this image and copyright information in PMC

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