Radiofrequency ablation for post infarction ventricular tachycardia. Report of a single centre experience of 112 cases.

Abstract

This report presents the largest consecutive series to date of radiofrequency ablation in the treatment of post infarction ventricular tachycardia. One hundred and twelve consecutive patients were studied, with an average of 12 documented episodes of ventricular tachycardia in the month preceding the radiofrequency ablation. Seventy-four percent of the subjects had an ejection fraction of less than 35%; 84% had more than one morphology of ventricular tachycardia and 30% had haemodynamically unstable ventricular tachycardia. The mean follow-up period was 61 months. Complete success defined as no inducible sustained monomorphic ventricular tachycardia was achieved in 38%. Modified result, defined as ventricular tachycardia only inducible by two stimuli more aggressive than at baseline was achieved in 34%. During follow-up, ventricular tachycardia recurred in 25 patients: 22 after a failed procedure, two following a modified result and one following a complete success. Twenty-five patients died: 13 of progressive cardiac failure and four of presumed arrhythmic causes, three after a failed procedure and one following a modified result. There were no procedure-related deaths. Procedural complications occurred in seven patients. In this report, radiofrequency ablation of post infarction ventricular tachycardia is a successful procedure with a low complication rate. Acute procedural success accurately predicts long-term freedom from recurrent ventricular tachycardia.