OBJECTIVES: The aim of this study was to expand data on outcomes for radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT) in young patients and to identify obstacles to success. BACKGROUND: Ablation of VT is performed infrequently in young patients. Published experience has been limited to case reports and small descriptive series. METHODS: A retrospective review of 97 consecutive VT ablation procedures involving 62 patients at a single institution from 1990 to 2003 was undertaken. All intention-to-treat procedures were analyzed. RESULTS: Mean age was 13.9 +/- 9.4 years. Procedures were categorized according to VT mechanism as follows: idiopathic right ventricle (n = 37); idiopathic left ventricle (n = 24); congenital heart disease (n = 20); or other structural disease (n = 16). Acute success was achieved in 58 (60%) of 97 procedures. Of the 39 failures, 33 were aborted cases due to inability to induce sufficient ectopy for mapping in 12, high-risk location near the His bundle or coronary artery in 11, unstable VT in 7, and anatomic obstacles in 3. Recurrence rate after acutely successful RFCA was 34% (20/58 procedures) at a mean follow-up of 3.8 +/- 2.0 years. Ultimately, long-term success was achieved in 38 (61%) of 62 patients after a mean of 1.6 +/- 0.9 procedures, with the highest success rate (87%) for idiopathic left ventricular tachycardia. CONCLUSIONS: When analyzed on a strict intention-to-treat basis, a long-term success rate of 61% is observed with ablation of VT in young patients. Inability to induce stable VT for precision mapping and certain high-risk VT locations can be significant obstacles to success.
OBJECTIVES: The aim of this study was to expand data on outcomes for radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT) in young patients and to identify obstacles to success. BACKGROUND: Ablation of VT is performed infrequently in young patients. Published experience has been limited to case reports and small descriptive series. METHODS: A retrospective review of 97 consecutive VT ablation procedures involving 62 patients at a single institution from 1990 to 2003 was undertaken. All intention-to-treat procedures were analyzed. RESULTS: Mean age was 13.9 +/- 9.4 years. Procedures were categorized according to VT mechanism as follows: idiopathic right ventricle (n = 37); idiopathic left ventricle (n = 24); congenital heart disease (n = 20); or other structural disease (n = 16). Acute success was achieved in 58 (60%) of 97 procedures. Of the 39 failures, 33 were aborted cases due to inability to induce sufficient ectopy for mapping in 12, high-risk location near the His bundle or coronary artery in 11, unstable VT in 7, and anatomic obstacles in 3. Recurrence rate after acutely successful RFCA was 34% (20/58 procedures) at a mean follow-up of 3.8 +/- 2.0 years. Ultimately, long-term success was achieved in 38 (61%) of 62 patients after a mean of 1.6 +/- 0.9 procedures, with the highest success rate (87%) for idiopathic left ventricular tachycardia. CONCLUSIONS: When analyzed on a strict intention-to-treat basis, a long-term success rate of 61% is observed with ablation of VT in young patients. Inability to induce stable VT for precision mapping and certain high-risk VT locations can be significant obstacles to success.
Authors: Edmond M Cronin; Frank M Bogun; Philippe Maury; Petr Peichl; Minglong Chen; Narayanan Namboodiri; Luis Aguinaga; Luiz Roberto Leite; Sana M Al-Khatib; Elad Anter; Antonio Berruezo; David J Callans; Mina K Chung; Phillip Cuculich; Andre d'Avila; Barbara J Deal; Paolo Della Bella; Thomas Deneke; Timm-Michael Dickfeld; Claudio Hadid; Haris M Haqqani; G Neal Kay; Rakesh Latchamsetty; Francis Marchlinski; John M Miller; Akihiko Nogami; Akash R Patel; Rajeev Kumar Pathak; Luis C Saenz Morales; Pasquale Santangeli; John L Sapp; Andrea Sarkozy; Kyoko Soejima; William G Stevenson; Usha B Tedrow; Wendy S Tzou; Niraj Varma; Katja Zeppenfeld Journal: J Interv Card Electrophysiol Date: 2020-10 Impact factor: 1.900
Authors: Elena K Grant; Charles I Berul; Russell R Cross; Jeffrey P Moak; Karin S Hamann; Kohei Sumihara; Ileen Cronin; Kendall J O'Brien; Kanishka Ratnayaka; Michael S Hansen; Peter Kellman; Laura J Olivieri Journal: J Cardiovasc Electrophysiol Date: 2017-03-28
Authors: Edmond M Cronin; Frank M Bogun; Philippe Maury; Petr Peichl; Minglong Chen; Narayanan Namboodiri; Luis Aguinaga; Luiz Roberto Leite; Sana M Al-Khatib; Elad Anter; Antonio Berruezo; David J Callans; Mina K Chung; Phillip Cuculich; Andre d'Avila; Barbara J Deal; Paolo Della Bella; Thomas Deneke; Timm-Michael Dickfeld; Claudio Hadid; Haris M Haqqani; G Neal Kay; Rakesh Latchamsetty; Francis Marchlinski; John M Miller; Akihiko Nogami; Akash R Patel; Rajeev Kumar Pathak; Luis C Sáenz Morales; Pasquale Santangeli; John L Sapp; Andrea Sarkozy; Kyoko Soejima; William G Stevenson; Usha B Tedrow; Wendy S Tzou; Niraj Varma; Katja Zeppenfeld Journal: Europace Date: 2019-08-01 Impact factor: 5.214
Authors: Philip L Wackel; Andrew W McCrary; Salim F Idriss; Samuel J Asirvatham; Bryan C Cannon Journal: Pediatr Cardiol Date: 2016-08-25 Impact factor: 1.655