Radiofrequency catheter ablation of ventricular tachyarrhythmia under navigation using EnSite array.

Abstract

BACKGROUND:

EnSite array (EA) provides virtual activation of ventricular tachycardia (VT) and premature ventricular contraction (PVC) on a beat-to-beat basis.

METHODS AND RESULTS:

Fifty-five consecutive patients (age 52+/-16 years) with 79 VTs/PVCs undergoing EA-guided radiofrequency catheter ablation (RFA) were studied, of whom 7 patients had organic heart diseases. A virtual activation map showed that 66 VTs/PVCs originated from the right ventricle (RV), including the RV outflow tract in 57, lateral wall of RV in 4, His bundle region in 3 and tricuspid annulus in 2. Ten VTs/PVCs originated from the left ventricle (LV), including the LV endocardium in 7 and aortic sinus cusp in 3. The origins of 3 PVCs, one each in 3 patients, were not identified. Six of 38 VTs were sustained and the remaining 32 VTs were non-sustained. RFA eliminated all but 3 focal PVCs, and all macroreentrant VTs at a critical conducting pathway, which was identified by the combined use of contact voltage and virtual activation maps. There were 11+/-9 applications, and the radiofrequency energy and fluoroscopy time were 11,354+/-13,360 J and 30+/-21 min, respectively. All patients with acute success were free of any symptoms during a follow up of 21+/-11 months.

CONCLUSIONS:

EA-guided RFA is safe and effective for VT/PVC, irrespective of its origin, mechanism, sustainability, hemodynamic condition, and underlying heart disease.

• Authors: Koji Miyamoto, Takeshi Tsuchiya, Sumito Narita, Yasutsugu Nagamoto, Takanori Yamaguchi, Shin-ichi Ando, Kiyoshi Hayashida, Yoshito Tanioka, Naohiko Takahashi
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 74 Issue 7 Pg. 1322-31 (Jul 2010) ISSN: 1347-4820 [Electronic] Japan
• PMID: 20467153 (Publication Type: Clinical Trial, Journal Article)

Topics

• Adult
• Aged
• Catheter Ablation (methods)
• Electrophysiologic Techniques, Cardiac (methods)
• Female
• Heart Conduction System (physiopathology)
• Humans
• Male
• Middle Aged
• Tachycardia, Ventricular (therapy)
• Treatment Outcome
• Ventricular Premature Complexes