[Treatment of resistant ventricular tachycardia with endocavitary ablation combined with anti-arrhythmia agents]

Abstract

Catheter ablation was used in 26 consecutive cases of high risk ventricular tachycardia (VT) resistant to antiarrhythmic therapy. Seven patients were in permanent VT at the time of catheter ablation, three of them were moribund. There were 10 cases of arrhythmogenic right ventricular dysplasia, 9 cases of VT complicating chronic myocardial infarction, 4 cases of dilated cardiomyopathy, 2 cases of idiopathic VT and one congenital cardiac malformation. Ten patients required 2 or more sessions of catheter ablation to treat their arrhythmia. Three of the 4 early deaths (less than 1 month) were due to technical problems. Combined with antiarrhythmic drugs in 8 cases, catheter ablation brought the VT under control in the 22 remaining patients. The follow-up period ranges from 10 to 28 months (average follow-up longer than 17 months). Catheter ablation is a technique which is currently under evaluation. The very encouraging results obtained in this series suggest that it may replace surgery in the treatment of chronic refractory VT.