[Radiofrequency ablation for verapamil-sensitive ventricular tachycardia].

OBJECTIVE

To assess the efficacy and safety of radiofrequency catheter ablation for verapamil-sensitive ventricular tachycardia (VT).

METHODS

A total of 18 patients with a diagnosis of verapamil-sensitive VT were enrolled in this study. Radiofrequency catheter ablation was administered after underwent examinations on admission to rule out structural heart disease. the ablation catheter was placed around the left posterior intermediate septum and left anteroseptal in the left ventricular to searching for the Purkinje potential (P potential). When the Purkinje potential preceded the surface QRS by ≥ 20 ms, it was considered as an ideal target for ablation. Ablation at 25 - 35 W, 60°C was often carried out at the point where the Purkinje potential was earliest. After ablation, perform programmed stimulation to measured the effects. The patients received routine postoperative treatment and care. And the follow-up period was 3 - 6 months after discharge.

RESULTS

17 patients diagnosed as ventricular raise from left posterior fascicle and 1 patient raise from left anterior fascicle were got to the radiofrequency end point and failed to elicit ventricular tachycardia again. In this patients, the Purkinje potential advanced to the starting point of QRS 20 ms were recognized as ideal point of radiofrequency. The length as the Purkinje potential advanced to the starting point of QRS are (24.0 ± 3.5) ms. the more length, the less times of radiofrequency. No postoperative complications were noted except for 2 patients who had mild hematoma at the site of puncture. During the follow-up period, 2 patients were found to have relapsed (recurrence rate = 11.1%) and showed transient resistance to verapamil. The remaining patients had no previous history of tachycardia.

CONCLUSION

With a low recurrence rate, radiofrequency ablation is a safe and efficacious cure for verapamil-sensitive VT. Despite some efficacies in the treatment of VT.