B-PO03-129 ABLATION FOR NONINDUCIBLE IDIOPATHIC VENTRICULAR TACHYCARDIA TARGETING PREMATURE VENTRICULAR COMPLEXES

Abstract

Idiopathic ventricular arrhythmias can present as isolated premature ventricular complexes (PVCs), nonsustained ventricular tachycardia, and sustained ventricular tachycardia (VT). It is not uncommon for these arrhythmias to arise from the same focus. Patients undergoing ablation for idiopathic VT are often not inducible and when present, PVCs with a similar morphology are frequently targeted for ablation. To determine the effectiveness of ablation targeting similar morphology PVCs in patients undergoing ablation for idiopathic VT where VT is not inducible during the electrophysiology study. We retrospectively analyzed 107 consecutive patients with a mean age of 48 (67% female gender) undergoing catheter ablation for idiopathic ventricular tachycardia. In 33 patients, VT was not inducible and PVCs with a similar morphology were targeted. The remaining 74 patients with inducible VT were used as a control group. The endpoints studied were acute procedural elimination of ventricular arrhythmias and clinical freedom from VT recurrence. Patients in whom PVCs were targeted as a surrogate for VT were more likely to have ventricular arrhythmias of left ventricular origin compared to the control group (39% vs. 20%, p=0.049). This group had an acute procedural success rate of 94% which was similar to the control group which had a success rate of 89% (p=0.72). Clinical freedom from VT without the use of antiarrhythmic medications over a mean follow up of 26 months was 90% in patients where PVCs were targeted, similar to the 88% freedom from recurrence in the control group (p=0.99). Patients with idiopathic VT often have PVCs with similar morphology to their clinical VT. In patients where VT is non-inducible during electrophysiology study, PVCs can provide a suitable target with similar short and long term outcomes.