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Catheter ablation of repetitive ventricular tachycardia in patients with ischemic heart disease – our experience

Zdravniški vestnik (Ljubljana, Slovenia : 1992), 2017-09, Vol.86 (7-8) [Peer Reviewed Journal]

Copyright ZDRAVNISKI VESTNIK - SLOVENIAN MEDICAL JOURNAL Jul-Aug 2017 ;ISSN: 1318-0347 ;EISSN: 1581-0224 ;EISSN: 1581-0024 ;DOI: 10.6016/ZdravVestn.1395

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  • Title:
    Catheter ablation of repetitive ventricular tachycardia in patients with ischemic heart disease – our experience
  • Author: Šinkovec, Matjaž ; Pernat, Andrej ; Antolič, Bor ; Klemen, Luka
  • Subjects: Cardiac arrhythmia ; Cardiomyopathy ; Cardiovascular disease ; catheter ablation ; Catheters ; clinical outcome ; coronary artery disease ; Homogenization ; ischaemic cardiomyopathy ; Ischemia ; radiofrequency ablation ; ventricular tachycardia
  • Is Part Of: Zdravniški vestnik (Ljubljana, Slovenia : 1992), 2017-09, Vol.86 (7-8)
  • Description: Ventricular tachycardia (VT) poses a significant risk for sudden death and heart failure exacerbation in patients with ischemic heart disease. Catheter-based radiofrequency ablation is the last treatment option for patients with frequent VT recurrences despite antiarrhythmic drugs. The aim was to present our retrospective catheter ablation data in this group of patients.The majority of 34 patients, who underwent percutaneous endocardial radiofrequency catheter ablation, were male, median age 67.5 years, who presented with electrical storm, had underlying cardiomyopathy after remote inferior wall myocardial infarction and preceding myocardial revascularization procedure, and had been implanted with cardioverter-defibrillator (ICD). Two ablation methods were used: linear ablation and/or scar homogenization. Acute ablation success (non-inducibility of any VT) was achieved in 59 % of procedures. VT could not be interrupted in 2 (6 %) patients. Pericardial tamponade that needed surgical intervention occurred in one procedure (2 %), and was related to inadvertent perforation of the right ventricular apex with a diagnostic catheter. Seven (20 %) patients died and additional 3 were lost from the median of 31 (6–151, rank) months of follow-up. No late VT recurrences were demonstrated in 20 (59 %) patients, and rare in 4 (12 %). Overall, the ablation procedure was successful in 71 % of patients.Catheter ablation gave very good long-term clinical result in about two-thirds of our patients with ischaemic cardiomyopathy and frequent VT recurrences. Catheter ablation, preferably with scar homogenization approach, should be considered early to reduce the number of VT episodes and ICD discharges.
  • Publisher: Ljubljana: ZDRAVNISKI VESTNIK - SLOVENIAN MEDICAL JOURNAL
  • Language: English;Slovenian
  • Identifier: ISSN: 1318-0347
    EISSN: 1581-0224
    EISSN: 1581-0024
    DOI: 10.6016/ZdravVestn.1395
  • Source: AUTh Library subscriptions: ProQuest Central
    Directory of Open Access Journals: DOAJ
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