Methods-Results
Fourty-seven consecutive patients (age 52±17 years) with VA undergoing electroanatomical mapping guided radiofrequency catheter ablation (RFA) were studied, of whom 20 patients had organic heart diseases. In the patients with idiopathic VA a virtual activation map showed that 17 VTs/PVCs originated from the right ventricle (RV), including the RV outflow tract in 15, lateral wall of RV in 1 and tricuspid annulus in 1. Ten VTs/PVCs originated from the left ventricle (LV), including the LV outflow tract in 4, fascicular VT in 2, mitral annulus in 1 and aortic sinus cusp in 1. One of these patients underwent epicardial ablation by video-assisted thoracoscopy due to epicardial origin of arrhythmia. In the patients with organic heart disease, scar-related ventricular tachycardia was the reponsible mechanism in 18 patients. Six patients underwent the procedure via substrat mapping, 2 of them due to electrical storm and 4 of them due to non inducable clinical VT. Two patients underwent ablation of the right branch of the His bundle due to bundle branch re-entry VT. There were 3 (6.3%) major complications observed in 47 patients. Access site vascular complications was seen in 1 patient and two patients had cardiac tamponade/hemopericardium. No procedural deaths occurred. Regarding RF ablation, more RF applications were required to eliminate the arrhythmia in organic heart disease patients (18.1±7.5 pulses vs. 8.9±3.7 pulses, P<0.01). During a mean follow-up period of 11.3±10.6 months, 5 (10.6%) patients (3 of structral heart disease and 2 of idiopathic groups) developed recurrences.
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