Radiofrequency ablation of haemodynamically unstable ventricular tachycardia after myocardial infarction

Objective-To determine whether radiofrequency (RF) ablation might have a ro le in haemodynamically unstable ventricular tachycardia. Methods-10 patients with a history of ventricular tachycardia producing hae modynamic collapse in whom drug treatment had failed and device therapy was rejected underwent RF ablation of ventricular tachycardia in sinus rhythm. The arrhythmogenic zone was defined on the basis of abnormal systolic move ment, the presence of fragmentation (low amplitude, prolonged multiphasic e lectrograms), and pace mapping. RF lesions were delivered in power mode in linear fashion within the defined arrhythmogenic zone. Results-Success (no ventricular tachycardia inducible postablation or at re test) was achieved in six patients, possible success (a different ventricul ar tachycardia inducible at more aggressive stimulation) in three. In one p atient, the procedure was abandoned because of poor catheter stability. The re were no clinical events during a mean (SD) follow up period of 23 (10) m onths in any of the nine patients defined as definite or possible successes . Conclusions-RF ablation for addressing haemodynamically unstable ventricula r tachycardia opens the door for the wider use of catheter ablation for tre ating this arrhythmia.