Abstract | BACKGROUND: METHODS AND RESULTS: Thirty-four patients (49±13 years; 74% male) with repaired congenital heart disease who underwent radiofrequency catheter ablation of VT in 2 centers were included. Twenty-two (65%) had a preserved left and right ventricular function. Patients were inducible for 1 (interquartile range, 1-2) VT, median cycle length: 295 ms (interquartile range, 242-346). Ablation aimed to transect anatomic isthmuses containing VT re-entry circuit isthmuses. Procedural success was defined as noninducibility of any VT and transection of the anatomic isthmus and was achieved in 25 (74%) patients. During long-term follow-up (46±29 months), all patients with procedural success (18/25 with internal cardiac defibrillators) were free of VT recurrence but 7 of 18 experienced internal cardiac defibrillator-related complications. One patient with procedural success and depressed cardiac function received an internal cardiac defibrillator shock for ventricular fibrillation. None of the 18 patients (12/18 with internal cardiac defibrillators) with complete success and preserved cardiac function experienced any ventricular arrhythmia. In contrast, VT recurred in 4 of 9 patients without procedural success. Four patients died from nonarrhythmic causes. CONCLUSIONS: In patients with repaired congenital heart disease with preserved ventricular function and isthmus-dependent re-entry, VT isthmus ablation can be curative.
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Authors | Gijsbert F L Kapel, Tobias Reichlin, Adrianus P Wijnmaalen, Sebastiaan R D Piers, Eduard R Holman, Usha B Tedrow, Martin J Schalij, William G Stevenson, Katja Zeppenfeld |
Journal | Circulation. Arrhythmia and electrophysiology
(Circ Arrhythm Electrophysiol)
Vol. 8
Issue 1
Pg. 102-9
(Feb 2015)
ISSN: 1941-3084 [Electronic] United States |
PMID | 25422392
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | © 2014 American Heart Association, Inc. |
Topics |
- Adult
- Boston
- Cardiac Catheterization
(adverse effects)
- Cardiac Surgical Procedures
(adverse effects)
- Defibrillators, Implantable
- Electric Countershock
(instrumentation)
- Electrocardiography
- Electrophysiologic Techniques, Cardiac
- Female
- Heart Defects, Congenital
(diagnosis, physiopathology, surgery)
- Humans
- Male
- Middle Aged
- Netherlands
- Predictive Value of Tests
- Recurrence
- Reoperation
- Risk Factors
- Tachycardia, Ventricular
(diagnosis, physiopathology, surgery)
- Time Factors
- Treatment Outcome
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