Document Detail

Nonsurgical transthoracic epicardial radiofrequency ablation: an alternative in incessant ventricular tachycardia.
MedLine Citation:
PMID:  12798578     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to analyze the feasibility, efficacy, and safety of epicardial radiofrequency (RF) ablation in patients with incessant ventricular tachycardia (VT). BACKGROUND: Management of patients with incessant VT is a difficult clinical problem. Drugs and RF catheter ablation are not always effective. A nonsurgical transthoracic epicardial RF ablation can be an alternative in patients refractory to conventional therapy. METHODS: Epicardial RF ablation was performed in 10 patients who presented with incessant VT despite the use of two or more intravenous antiarrhythmic drugs. RESULTS: In eight patients, endocardial ablation (EdA) failed to control the tachycardia. In the remaining two patients, epicardial ablation (EpA) was first attempted because of left ventricular thrombus and severe artery disease, respectively. Eight patients had a diagnosis of coronary artery disease with healed myocardial infarction. One patient had dilated cardiomyopathy, and one patient had idiopathic, incessant VT. In patients with structural heart disease, the mean ejection fraction was 0.28 +/- 0.10%. Four patients previously received an implantable defibrillator. The EpA effectively terminated the incessant tachycardia in eight patients, which represents a success rate of 80%. In them, after a follow-up of 18 +/- 18 months, a single episode of a different VT was documented in one patient. No significant complications occurred related to the procedure. CONCLUSIONS: In patients with incessant VT despite the use of drugs or standard EdA, the epicardial approach was very effective and should be considered as an alternative in this life-threatening situation.
Josep Brugada; Antonio Berruezo; Alejandro Cuesta; Joaquin Osca; Enrique Chueca; Xavier Fosch; Luis Wayar; Lluis Mont
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  41     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-11     Completed Date:  2003-07-18     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2036-43     Citation Subset:  AIM; IM    
Arrhythmia Section, Cardiovascular Institute, Hospital Clinic, University of Barcelona, Villaroel 170, 08036 Barcelona, Spain.
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MeSH Terms
Bundle-Branch Block / diagnosis,  physiopathology,  therapy
Catheter Ablation*
Coronary Angiography
Coronary Artery Disease / diagnosis,  physiopathology,  therapy
Defibrillators, Implantable
Follow-Up Studies
Middle Aged
Pericardium / surgery*
Postoperative Complications / etiology,  therapy
Stroke Volume / physiology
Tachycardia, Ventricular / diagnosis,  physiopathology,  therapy*
Treatment Outcome
Comment In:
J Am Coll Cardiol. 2003 Jun 4;41(11):2044-5   [PMID:  12798579 ]

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