Radiofrequency catheter ablation of ventricular tachycardia in patients with coronary artery disease

Purpose. We analyze the efficacy of radiofrequency catheter ablation and th e clinical significance of inducible ventricular tachycardia that had never been documented before (non clinical ventricular tachycardia) in patients with ventricular tachycardia and coronary artery disease. Methods. Thirty-four patients (30 men, aged gl +/- 10 years, left ventricul ar ejection fraction 31 +/- 10%) with coronary artery disease and documente d clinical ventricular tachycardia underwent radio-frequency ablation. Thir ty-four clinical ventricular tachycardia and 11 non clinical ventricular ta chycardia were treated with radiofrequency. Initial therapeutic success was considered when none of the ventricular tachycardia treated with radiofreq uency could no longer be induced at the last stimulation protocol before di scharge. Results. Clinical ventricular tachycardia was successfully ablated in 23 pa tients (68%). Initial therapeutic success was obtained in 21 patients (62%) . In 6 of them, 7 non clinical ventricular tachycardia poor tolerated were also induced. During a mean follow-up of 26 +/- 15 months ventricular tachy cardia recurred in 6 patients (29%). Five of the 6 patients who recurred we re discharged with no inducible non clinical ventricular tachycardia. Three patients died during the follow-up. Two of them from heart failure (one wi th previous recurrence) and the other suddenly with documented asystolia af ter loss of consciousness without previous recurrence. Conclusions. In our series of patients with ventricular tachycardia and cor onary artery disease selected for radiofrequency ablation, acute success ma s obtained in 62%. After a mean follow-up of 2 years, 44% of all the patien ts were free from ventricular tachycardia. Although the possibility of vent ricular tachycardia recurrence is high (29%), the recurrence rate is not in creased by the inducibility of non clinical ventricular tachycardia.