Long-term follow-up of idiopathic ventricular fibrillation ablation: a multicenter study.

Abstract

OBJECTIVES:

This multicenter study sought to evaluate the long-term follow-up of patients ablated for idiopathic ventricular fibrillation (VF).

BACKGROUND:

Catheter ablation of idiopathic VF that targets ventricular premature beat (VPB) triggers has been shown to prevent VF recurrences on short-term follow-up.

METHODS:

From January 2000, 38 consecutive patients from 6 different centers underwent ablation of primary idiopathic VF initiated by short coupled VPB. All patients had experienced at least 1 documented VF, with 87% having experienced > or =2 VF episodes in the preceding year. Catheter ablation was guided by activation mapping of VPBs or pace mapping during sinus rhythm.

RESULTS:

There were 38 patients (21 men) age 42 +/- 13 years, refractory to a median of 2 antiarrhythmic drugs. Triggering VPBs originated from the right (n = 16), the left (n = 14), or both (n = 3) Purkinje systems and from the myocardium (n = 5). During a median post-procedural follow-up of 63 months, 7 (18%) of 38 patients experienced VF recurrence at a median of 4 months. Five of these 7 patients underwent repeat ablation without VF recurrence. Survival free of VF was predicted only by transient bundle-branch block in the originating ventricle during the electrophysiological study (p < 0.0001). The number of significant events (confirmed VF or aborted sudden death) was reduced from 4 (interquartile range 3 to 9) before to 0 (interquartile range 0 to 4) after ablation (p = 0.01).

CONCLUSIONS:

Ablation for idiopathic VF that targets short coupled VPB triggers is associated with a long-term freedom from VF recurrence.

• Authors: Sébastien Knecht, Frédéric Sacher, Matthew Wright, Mélèze Hocini, Akihiko Nogami, Thomas Arentz, Bertrand Petit, Robert Franck, Christian De Chillou, Dominique Lamaison, Jéronimo Farré, Thomas Lavergne, Thierry Verbeet, Isabelle Nault, Seiichiro Matsuo, Lionel Leroux, Rukshen Weerasooriya, Bruno Cauchemez, Nicolas Lellouche, Nicolas Derval, Sanjiv M Narayan, Pierre Jaïs, Jacques Clementy, Michel Haïssaguerre
• Journal: Journal of the American College of Cardiology (J Am Coll Cardiol) Vol. 54 Issue 6 Pg. 522-8 (Aug 04 2009) ISSN: 1558-3597 [Electronic] United States
• PMID: 19643313 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Body Surface Potential Mapping
• Catheter Ablation
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Recurrence
• Survival Analysis
• Time Factors
• Ventricular Fibrillation (therapy)