Benefit of Post-Radio-Frequency Ablation (RFA) under Electro-Anatomical Mapping (EAM) in the Idiopathic Outflow Tract Ventricular Tachycardia (VT) or Premature Ventricular Complex (PVC) Patients at Central Chest Institute of Thailand (CCIT) Single Center Study
Keywords:
Electro-anatomical mapping (EAM), Outflow tract, Premature ventricular contraction (PVC), Ventricular tachycardia (VT)Abstract
Cardiac Electrophysiologic Study under Electro-anatomical mapping and Radio-frequency ablation (RFA) is currently for treat cardiac arrhythmias. The study aimed to assess the benefit and safety of treatment for idiopathic ventricular outflow tract,either premature ventricular complex (PVC) or ventricular (VT). A retrospective study of 59 patients at the Central Chest Institute of Thailand between 1 January 2017 and 31 October 2018 with the follow-up period more than six months conducted. The average age of patients was 47.53 years old, female 78% and male 22%. The most common site of origin PVC or VT was at the right ventricular outflow tract, which detected up to 93.3% by 12-leads electrocardiogram criteria to 89.9% by electro-anatomical method. The success rate of radiofrequency ablation was 81.4%, unsuccessful cases depend on the site of origin of rate 18.6% comparable with the previous study.The cause of unsuccess rate depended on the site of origin PVC or VT. The complication rate was 5.1%, cardiac tamponade 3.4% and bleeding of puncture site 1.7% respectively. The recurrence rate at 1 year was 8.5%. In conclusion, the Cardiac Electrophysiologic study under Electro-anatomical mapping for treatment of outflow tract VT and PVC were safe, effectively and low recurrence rate at 1 year.
References
Jackson J, Sanjay D. Idiopathic outflow Tract ventricular Tachycardia. In: Kartikeya Bhargava, Samuel J Asirvatham, eds Practical Cardiac Electrophysiology. 1st ed. Philadelphia: Jaypeebrothers; 2017. p.531-532.
Marchlinski FE, Deely MP, Zado ES. Sex-specific triggers for right ventricular outflow tract tachycardia. Am Heart J 2000; 139:1009-13.
Tanawuttiwat T, Nazarian S, Hugh Calkins. The role of catheter ablation in the management of ventricular tachycardia. European Heart Journal 2016; 37:594-609.
Nakagawa M, Takahashi N, Nobe S, Ichinose M, Ooei T, Yufu F, et al. Gender difference in various type of idiopathic ventricular tachycardia. J Cardiovascular Electrophysiol 2002; 13:633-8.
Lerman BB, Stein KM, Markowitz SM, Idiopathic right ventricular outflow tract tachycardia: a clinical approach. Pacing Clin Electrophysiol 1996; 19:2120-37.
Anter E, Dixit S. Ablation of Ventricular Outflow Tract Tachycardias. In: Huang SKS, Miller JM, eds. Catheter Ablation of Cardiac Arrhythmias. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015. P.519-539.
Hoffmayer KS, Machado ON, Marcus GM, Yang Y, Johnson CJ, Ermakov S, et al. Electrocardiographic comparison of ventricular arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy and right ventricular outflow tract tachycardia. J Am Coll Cardiol 2011; 58:831-8.
Dukes JW, Dewland TA, Vittinghoff E, Mandyam MC, Heckbert SR, Siscovick DS, et al. Ventricular ectopy as a predictor of heart failure and death. J Am Coll of Cardiol 2015; 66:101-9.
Yarlagada RK, Iwai S, Stein KM, Markowitz SM, Shah BK, Cheung JW, et al. Reversal of cardiomyopathy in patients with repetitive monomorphic ventricular ectopy originating from the right ventricular outflow tract. Circulation 2005; 112: 1092-7.
Takamoto M, Yoshimura H, Ohba Y, Matsumoto Y, Yamamoto U, Mohri M, et al. Radiofrequency catheter ablation of premature ventricular complexes from right ventricular outflow tract improves left ventricular dilation and clinical status in patients without structural heart disease. J Am Coll Cardiol 2005; 45: 1259-65.
Baman TS, Lange DC, Ilg KJ, Gupta SK, Liu T-Y, Alguire C, et al. Relationship between burden of premature ventricular complex and left ventricular function. Heart Rhythm 2010; 7:865-9.
Ban JE, Park HC, Park JS, Ngamoto Y, Choi JI, Lim HE, et al. Electrocardiographic and electrophysiological characteristics of premature ventricular complexes associated with left ventricular dysfunction in patients without structural heart disease. Europace 2013; 15:735-41.
Del Carpio Munoz F, Syed FF, Noheria A, Cha Y-M, Friedman PA, Hammill SC, et al. Characteristics of premature ventricular complexes as correlates of reduced left ventricular systolic function: study of burden, duration, coupling interval, morphology and site of origin of PVCs. J Cardiovasc Electrophysiol 2011; 22: 791-8.
Yokokawa M, Kim HM, Good E, Crawford T, Chugh A, Pelosi Jr, et al. Impact of QRS duration of frequent premature ventricular complexes on the development of cardiomyopathy.
Heart Rhythm 2012; 22:1460-4.
Carbelleira Pol L, Deyell MW, Frankel DS, Benhayon D, Squara F, Chik W, et al. Ventricular premature depolarization QRS duration as a new marker of risk for the development of ventricular premature depolarization induced cardiomyopathy. Herat Rhythm 2014; 11:299-306.
Kawamura M, Badhwar N, Vedantham V, Tseng ZH, Lee BK, Lee RJ, et al. Coupling interval dispersion and body mass index are independent predictors of idiopathic premature ventricular complex-induced cardiomyopathy. J Cardiovasc Electrophysiol 2014; 25:756-62.
Gill JS, Blaszyk K, Ward DE, Camm AJ. Verapamil for the suppression of idiopathic ventricular tachycardia of left bundle branch block-like morphology. Am Heart J 1993; 126:1126-33.
Issa ZF, Miller JM, Zipes DP. CHAPTER 19 – Idiopathic Ventricular Tachycardia. In Zipes ZFIMMP, (ED). Clinical Arrhythmology and Electrophysiology (1). Philadelphia: W.B. Saunders; 2009. p.440-461.
Latchamsetty R, Yokokawa M, Morady F, Kim HM, Mathew S, Tilz R, et al. Multicenter outcomes for catheter ablation of idiopathic premature ventricular complexes. JACC Clin Electrophysiol 2015; 1:116-23.
Zhong L, Lee YH, Huang XM, Asirvatham SJ, Shen WK, Friedman PA, et al. Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions: a single-center retrospective study. Heart Rhythm 2014; 11:187-93.
Ling Z, Liu Z, Zipunnikov V, Wu J, Du H, Woo K, et al. Radiofrequency ablation versus antiarrhythmic medication for treatment of ventricular premature beats from the right ventricular outflow tract: prospective randomized study. Circ Arrhythm Electrophysiol 2014; 7: 237-43.
Liang JJ, Han Y, Frankel DS. Ablation of outflow tract ventricular tachycardia. Curr Treat Options Cardiovasc Med 2015; 17:1-10.
Mehrotra A, Dixit S. Electrocardiogram characteristics of outflow tract ventricular tachycardia. Card Electrophysiol Clin 2014; 6: 553-65.
Yamada T, Litovsky SH, Kay GN. The left ventricular ostium: an anatomic concept relevant to idiopathic ventricular arrhythmias. Circ Arrhythm Electrophysiol 2008; 1: 3963-404.
Jackson J, Sanjay D. Idiopathic outflow Tract ventricular Tachycardia. In: Kartikeya Bhargava, Samuel J Asirvatham, eds Practical Cardiac Electrophysiology. 1st ed. Philadelphia: Jaypeebrothers; 2017. p.535-538.
Matthew T, Marc W, Nathaniel H, Andrew D, Laurent M, Stanley N. Ventricular Tachycardia. In: Jason G, eds. The clinical electrophysiology. 1st ed. Minneapolis: Cardiotext Publishing; 2016. p.229-62.
Hygriv Rao B. Measurements of basic interval, refractory periods and programmed electrical stimulation. In: Kartikeya Bhargava, Samuel J Asirvatham, eds Practical Cardiac Electrophysiology. 1st ed. Philadelphia: Jaypeebrothers; 2017. p.43-53.
Freddy del-Carpio M, Samuel J. Three-dimensional mapping of cardiac arrhythmiad: Techniques, Principles and Application. In: Kartikeya Bhargava, Samuel J Asirvatham, eds Practical Cardiac Electrophysiology. 1st ed. Philadelphia: Jaypeebrothers; 2017. p.149-167.
Tahmeed C, Roderick T, Noel G, Kalyanam S. Epicardial Ablation: Techniques and Applications. In: Kartikeya Bhargava, Samuel J Asirvatham, eds Practical Cardiac Electrophysiology. 1st ed. Philadelphia: Jaypeebrothers; 2017. p.717-725.
Abhishek D, Paul F. Radiofrequency Ablation: Principles and Biophysics. In: Kartikeya Bhargava, Samuel J Asirvatham, eds Practical Cardiac Electrophysiology. 1st ed. Philadelphia: Jaypeebrothers; 2017. p.169-186.
Downloads
Published
How to Cite
Issue
Section
License
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของกรมการแพทย์ กระทรวงสาธารณสุข
ข้อความและข้อคิดเห็นต่างๆ เป็นของผู้เขียนบทความ ไม่ใช่ความเห็นของกองบรรณาธิการหรือของวารสารกรมการแพทย์
