Catheter ablation for ventricular tachycardia in ischaemic heart disease; Acute success and long-term outcome

Abstract

Objectives. We conducted a study to assess the acute procedural success and the long-term effect of radiofrequency ablation (RFA) for ventricular tachycardia (VT) in patients with ischaemic heart disease. Design. We included 90 patients with ischaemic heart disease treated with RFA for VT in our institution. Data were obtained from patient files, and implantable cardioverter-defibrillator (ICD) discharges were recorded from in-house and remote follow-up data. Recurrence of VT during follow-up was noted as date of first ICD therapy for VT or first recurrence of symptomatic VT. Results. After the initial RFA procedure no VT was inducible in 42 patients (47%), non-clinical VT was inducible in 21 patients (23%), and the clinical VT was still inducible in 14 patients (16%). The procedural success was indefinable in 13 patients (14%). After a median follow-up of 33 months after the latest RFA, 38 patients (42%) stayed free from recurrent VT. The number of ICD shocks/year was significantly reduced from median 1.1 (interquartile range: 0.3–2.8) to 0 (0–0.4) (p < 0.0001). Conclusions. Procedural success rate as well as long-term freedom from recurrent VT is modest after RFA for VT in ischaemic heart disease. However, ICD discharges are significantly reduced after RFA, and a considerable proportion of patients remain free from recurrent VT during the long-term follow-up.