Document Detail


Reentry Using Anatomically Determined Isthmuses: A Curable Ventricular Tachycardia in Repaired Congenital Heart Disease.
MedLine Citation:
PMID:  25422392     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -Ventricular tachycardia (VT) is an important cause of late morbidity and mortality in repaired congenital heart disease (rCHD). The substrate often includes anatomical isthmuses that can be transected by radiofrequency catheter ablation (RFCA) similar to isthmus block for atrial flutter. This study evaluates the long-term efficacy of isthmus block for treatment of reentry VT in adults with rCHD.
METHODS AND RESULTS: -Thirty-four patients (49±13 years, 74% male) with rCHD who underwent RFCA of VT in two centres were included. Twenty-two (65%) had a preserved left and right ventricular function. Patients were inducible for 1 (IQR 1-2) VT, median cycle length 295ms (IQR 242-346). Ablation aimed to transect anatomical isthmuses containing VT reentry circuit isthmuses. Procedural success was defined as non-inducibility of any VT and transection of the anatomical isthmus and was achieved in 25 (74%) patients. During long-term follow-up (46±29 months) all patients with procedural success (18/25 with ICDs) were free of VT recurrence but 7/18 experienced ICD related complications. One patient with procedural success and depressed cardiac function received an ICD shock for VF. None of the 18 patients (12/18 with ICDs) with complete success and preserved cardiac function experienced any ventricular arrhythmia. In contrast, VT recurred in 4/9 patients without procedural success. Four patients died from non-arrhythmic causes.
CONCLUSIONS: -In patients with rCHD with preserved ventricular function and isthmus dependent reentry, VT isthmus ablation can be curative.
Authors:
Gijsbert F L Kapel; Tobias Reichlin; Adrianus P Wijnmaalen; Sebastiaan R D Piers; Eduard R Holman; Usha B Tedrow; Martin J Schalij; William G Stevenson; Katja Zeppenfeld
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-24
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-25     Completed Date:  -     Revised Date:  2014-11-26    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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