J. Mukai et al., LONG-TERM RESULTS OF CATHETER ABLATION FOR IDIOPATHIC VENTRICULAR-TACHYCARDIA ORIGINATED FROM THE RIGHT-VENTRICULAR OUTFLOW, Japanese Circulation Journal, 57(10), 1993, pp. 960-968
We performed catheter ablation in 10 consecutive patients with idiopat
hic monomorphic right ventricular tachycardia and studied the long-ter
m outcome. All ventricular tachycardias had a left bundle branch block
configuration with an inferior axis, and originated from right ventri
cular outflow. Antiarrhythmic drugs (3-6 drugs) had been ineffective i
n controlling ventricular tachycardia. The 2 patients who underwent di
rect-current ablation (2 shocks of 150 J) had no recurrence of ventric
ular tachycardia and did not require antiarrhythmic drugs during a fol
low-up of 56 and 51 months, respectively. Of the 8 patients who underw
ent radiofrequency ablation (30-40 watt, 20-40 sec, 2 - 15 application
, using Inter Nova RA 50, 13.56 MHz), 1 patient had no rccurrence of v
entricular tachycardias and did not require antiarrhythmic drugs, 4 pa
tients had no recurrence of ventricular tachycardias but did require a
ntiarrhythmic drugs, and 3 patients experienced recurrence of non-sust
ained ventricular tachycardia despite the use of antiarrhythmic drugs
during a follow-up of 15 40 months. There were no complications except
for cardiac perforation which occurred immediately after direct-curre
nt ablation in 1 patient. In conclusion, long-term success in preventi
ng ventricular tachycardia was achievable with direct-current ablation
, but this success was associated with serious risks, such as cardiac
perforation. Radiofrequency ablation was safer than direct-current abl
ation, but had a lower long-term success rate.