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European Heart Journal 1991 12(12):1257-1265;
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Radiofrequency catheter ablation in recurrent ventricular tachycardia

B. D. GONSKA, S. BRUNE, K. P. BETHGE and H. KREUZER

Department of Cardiology, University of Goettingen Germany

Received 6 August 1990; revised 6 December 1990; .

Correspondence: Bernd-Dieter Gonska, MD, Medizinische Universitatsklinik Abt, Kardiologie. Robert-Koch 40, D-3400 Goettingen, Germany

Abstract

Catheter ablation by radiofrequency energy was carried out in 10 patients with one type of recurrent monomorphic sustained ventricular tachycardia resistant to medical antiarrhythrnic management. Electrophysiological studies before ablation included activation and pace-mapping. In all patients, the origin of the tachycardia was localized in the left ventricle; in the septum in six, at the posterolateral wall in three and anterobasal in one. The earliest onset of endocardial activation preceding the QRS complex during ventricular tachycardia ranged between -45 and -90 ms. Transcatheter ablation was performed with a bipolar or quadripolar catheter using a radiofrequency generator (HAT 100, Osypka). No complications occurred during the ablation procedure. Thereafter, in all patients, the clinical tachycardia was no longer inducible by programmed stimulation. During a follow-up period of 22 to 32 months including eight patients, the tachycardia recurred in two; one of these patients subsequently died suddenly. A third patient had one episode of a new type of sustained ventricular tachycardia some hours after catheter ablation. In the remaining patients, there was no recurrence of symptctnatic tachycardia under maintainance of the antiarrhythmic management which, prior to ablation had been ineffective.

Thus, our preliminary results suggest that radiofrequency catheter ablation might be beneficial for these high risk patients.

Key Words: Radiofrequency current • catheter ablation • ventricular tachycardia


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