RADIOFREQUENCY CATHETER ABLATION OF VENTRICULAR-TACHYCARDIA IN 26 PATIENTS

Citation
Fz. Wang et al., RADIOFREQUENCY CATHETER ABLATION OF VENTRICULAR-TACHYCARDIA IN 26 PATIENTS, Chinese medical journal, 108(9), 1995, pp. 674-677
Citations number
5
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medicine, General & Internal
Journal title
ISSN journal
0366-6999
Volume
108
Issue
9
Year of publication
1995
Pages
674 - 677
Database
ISI
SICI code
0366-6999(1995)108:9<674:RCAOVI>2.0.ZU;2-I
Abstract
Electrophysiology study and radiofrequency catheter ablation (RFCA) we re performed in 26 patients with refractory sustained ventricular tach ycardia (VT). After induction of VT, 12-lead electrocardiogram (ECG) w as recorded and QRS morphology and axis of induced VT were studied to identify the origin of VT. The precise site of VT origin were localize d by pace mapping and activation mapping carefully. RF energy was deli vered through a big-tip deflectable electrode catheter when the earlie st site of endocardial activation and a high-frequency and low-amplitu de potential of Purkinje fiber, pre ceding surface QRS by more than 25 ms, were identified and/or a pace map was obtained showing identical QRS complexes in at least 11 of 12 ECG leads. VTs were ablated success fully in 24 of 26 patients (success rate was 92%). For successful abla tion, it is essential that the pace map QRS morphology in 12 leads sho uld be identical with that in spontaneous or induced VT as far as poss ible in performing pace map ping. Pace mapping is safe, simple and has no unfavourable effect on hemodynamics although it takes longer time. Activation mapping takes shorter time and has a high success rate. QR S configuration in spontaneous VT can help to localize the site of VT origin. Deliberate mapping at the site suggested to bo the origin of V T by surface ECG can shorten the duration of map ping and increase the success rate of RFCA, RFCA of VT in patients without structural heart disease is effective, safe, and has a high success rate, so it may be considered as an early therapy for these patients.