Document Detail


Catheter ablation of incessant ventricular tachycardia: acute and long-term results.
MedLine Citation:
PMID:  8737107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
SUBJECTS: Seventeen patients with incessant ventricular tachycardia refractory to anti-arrhythmic therapy underwent catheter ablation between 1987 and 1993. Fifteen patients had coronary heart disease and two had dilated cardiomyopathy. The mean age of the patients was 65 +/- 8 and the mean left ventricular ejection fraction was 31 +/- 9%. METHODS: Ablation sites were selected on the basis of endocardial activation mapping, concealed entrainment or bundle branch mapping. Catheter ablation was performed with direct current in nine patients and with radiofrequency energy in eight patients. Incessant ventricular tachycardia was terminated by catheter ablation in all 17 patients. RESULTS: One patient died after the ablation procedure due to pericardial tamponade. During electrophysiological testing 5-14 days later, 7 of 16 patients (44%) had inducible sustained or non-sustained ventricular tachycardia. Five of them underwent implantation of an automatic cardioverter/defibrillator, and three of these experienced discharges of the device during a mean follow-up of 30 +/- 12 months. another patient underwent implantation of a cardioverter/defibrillator after spontaneous recurrence of ventricular tachycardia. Out of the nine patients without inducible ventricular tachycardia, one died as a result of sudden cardiac death, and another had spontaneous ventricular tachycardia. Thus, ventricular tachycardia recurred clinically in 6 of 16 patients (38%), in whom ventricular tachycardia with the same morphology as that of the ablated ventricular tachycardia could be determined only in one patient. CONCLUSION: Catheter ablation is the method of choice for the emergency treatment of patients with incessant ventricular tachycardia. Due to the high risk of recurrence, additional anti-arrhythmic management, such as the implantation of a cardioverter/defibrillator, has to be considered.
Authors:
K Cao; B D Gonska
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  17     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-12-09     Completed Date:  1996-12-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  756-63     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospital Göttingen Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Catheter Ablation*
Defibrillators, Implantable
Echocardiography
Electrocardiography
Electrophysiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Tachycardia, Ventricular / physiopathology,  surgery*,  therapy
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Eur Heart J. 1996 May;17(5):647-8   [PMID:  8737089 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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