Title: Catheter radiofrequency ablation of right ventricular outflow tract tachycardia guided by non-contact mapping
Abstract: Objective The radiofrequency (RF)ablation of right ventricular outflow tract (RVOT)tachycar-dia is usually time consuming or difficult. This study was to determine whether the non-contact mapping is reliable in RVOT ventricular tachycardia (VT) ablation. Methods Twenty patients (12 males, 8 females) with average (36.0 ± 12.7)years old were enrolled. Of whom, 6 patients with syncope or presyncope attacks, 7 were previously failed in routine catheter RF ablation. Non-contact mapping was performed during sinus rhythm and ventricular tachycardia in all patients and RF ablation was applied under the guidance of non-contact mapping. Results There were 22 VTs and 3 premature ventricular contractions (PVCs)induced in 20 patients. Electrical scar zone was identified in 13 patients and 11 VTs were found to be originating from the scar zones. With all 25 substrates, 10 located in septum, 7 in mid-or inferior posterior wall, 4 in anterior, 3 in free wall and 1 in pulmonary valve area. The average diameter of the substrates was (16.8 ±9.2) mm. The activation sequence on non-contact mapping showed the potentials on targeting sites was (41.0 ± 13.8)ms earlier than the body surface electrogram . During pace mapping, compared with spontaneous VTs or PVCs, there were 12/12 leads identical in 14 cases, 11/12 leads identical in 10 and 10/12 leads identical in 1 case. The successful ablation was achieved with all VTs and PVCs. One patient had infrequent PVCs ( 2 000/24 h)during a follow-up of (12.0 ± 6.2) months. No complications occurred during and after ablation. Conclusion Non-contact mapping reveals that an electrical scar zone, which is also the substrate, exists in the majority of RVOT VT patients. The non-contact mapping technique may lead to a high successful rate in RVOT VT ablation, especially in difficult cases.
Publication Year: 2003
Publication Date: 2003-01-01
Language: en
Type: article
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