Radiofrequency catheter ablation of postinfarction ventricular tachycardia: Long-term success and the significance of inducible nonclinical arrhythmias

Steven A. Rothman, Henry H. Hsia, Sergio F. Cossú, I. Lisa Chmielewski, Alfred E. Buxton, John Miller

Research output: Contribution to journalArticle

138 Citations (Scopus)

Abstract

Background: Radiofrequency (RF) catheter ablation is effective therapy for monomorphic ventricular tachycardia (VT) in patients without structural heart disease. In patients with postinfarction VT; however, this procedure has been used predominantly as adjunctive therapy, targeting only the patient's clinically documented arrhythmia. By targeting all inducible, sustained VT morphologies, we sought to determine the utility of RF catheter ablation as a primary cure in patients who present with hemodynamically tolerated VT. Methods and Results: RF ablation was attempted in 35 patients with a previous myocardial infarction and recurrent, hemodynamically tolerated VT. A mean of 3.9±2.7 VTs were induced per patient (range, 1 to 10). The clinically documented arrhythmia was successfully ablated in 30 of 35 patients (86%), and on follow-up electrophysiological testing, 11 patients had no inducible VT and were discharged without other therapy. Nineteen patients had inducible 'nonclinical' arrhythmias on follow-up testing, and the majority underwent cardiac defibrillator implantation. Freedom from recurrent arrhythmias, including sudden death, was 91% in patients without inducible VT and 53% in patients with persistently inducible 'nonclinical' arrhythmias (P

Original languageEnglish (US)
Pages (from-to)3499-3508
Number of pages10
JournalCirculation
Volume96
Issue number10
StatePublished - Nov 18 1997
Externally publishedYes

Fingerprint

Catheter Ablation
Ventricular Tachycardia
Cardiac Arrhythmias
Defibrillators
Sudden Death
Heart Diseases
Therapeutics
Myocardial Infarction

Keywords

  • Catheter ablation
  • Coronary disease
  • Tachyarrhythmias
  • Tachycardia

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Radiofrequency catheter ablation of postinfarction ventricular tachycardia : Long-term success and the significance of inducible nonclinical arrhythmias. / Rothman, Steven A.; Hsia, Henry H.; Cossú, Sergio F.; Chmielewski, I. Lisa; Buxton, Alfred E.; Miller, John.

In: Circulation, Vol. 96, No. 10, 18.11.1997, p. 3499-3508.

Research output: Contribution to journalArticle

Rothman, Steven A. ; Hsia, Henry H. ; Cossú, Sergio F. ; Chmielewski, I. Lisa ; Buxton, Alfred E. ; Miller, John. / Radiofrequency catheter ablation of postinfarction ventricular tachycardia : Long-term success and the significance of inducible nonclinical arrhythmias. In: Circulation. 1997 ; Vol. 96, No. 10. pp. 3499-3508.
@article{085a566394c346f8a62d8be87ae062c2,
title = "Radiofrequency catheter ablation of postinfarction ventricular tachycardia: Long-term success and the significance of inducible nonclinical arrhythmias",
abstract = "Background: Radiofrequency (RF) catheter ablation is effective therapy for monomorphic ventricular tachycardia (VT) in patients without structural heart disease. In patients with postinfarction VT; however, this procedure has been used predominantly as adjunctive therapy, targeting only the patient's clinically documented arrhythmia. By targeting all inducible, sustained VT morphologies, we sought to determine the utility of RF catheter ablation as a primary cure in patients who present with hemodynamically tolerated VT. Methods and Results: RF ablation was attempted in 35 patients with a previous myocardial infarction and recurrent, hemodynamically tolerated VT. A mean of 3.9±2.7 VTs were induced per patient (range, 1 to 10). The clinically documented arrhythmia was successfully ablated in 30 of 35 patients (86{\%}), and on follow-up electrophysiological testing, 11 patients had no inducible VT and were discharged without other therapy. Nineteen patients had inducible 'nonclinical' arrhythmias on follow-up testing, and the majority underwent cardiac defibrillator implantation. Freedom from recurrent arrhythmias, including sudden death, was 91{\%} in patients without inducible VT and 53{\%} in patients with persistently inducible 'nonclinical' arrhythmias (P",
keywords = "Catheter ablation, Coronary disease, Tachyarrhythmias, Tachycardia",
author = "Rothman, {Steven A.} and Hsia, {Henry H.} and Coss{\'u}, {Sergio F.} and Chmielewski, {I. Lisa} and Buxton, {Alfred E.} and John Miller",
year = "1997",
month = "11",
day = "18",
language = "English (US)",
volume = "96",
pages = "3499--3508",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Radiofrequency catheter ablation of postinfarction ventricular tachycardia

T2 - Long-term success and the significance of inducible nonclinical arrhythmias

AU - Rothman, Steven A.

AU - Hsia, Henry H.

AU - Cossú, Sergio F.

AU - Chmielewski, I. Lisa

AU - Buxton, Alfred E.

AU - Miller, John

PY - 1997/11/18

Y1 - 1997/11/18

N2 - Background: Radiofrequency (RF) catheter ablation is effective therapy for monomorphic ventricular tachycardia (VT) in patients without structural heart disease. In patients with postinfarction VT; however, this procedure has been used predominantly as adjunctive therapy, targeting only the patient's clinically documented arrhythmia. By targeting all inducible, sustained VT morphologies, we sought to determine the utility of RF catheter ablation as a primary cure in patients who present with hemodynamically tolerated VT. Methods and Results: RF ablation was attempted in 35 patients with a previous myocardial infarction and recurrent, hemodynamically tolerated VT. A mean of 3.9±2.7 VTs were induced per patient (range, 1 to 10). The clinically documented arrhythmia was successfully ablated in 30 of 35 patients (86%), and on follow-up electrophysiological testing, 11 patients had no inducible VT and were discharged without other therapy. Nineteen patients had inducible 'nonclinical' arrhythmias on follow-up testing, and the majority underwent cardiac defibrillator implantation. Freedom from recurrent arrhythmias, including sudden death, was 91% in patients without inducible VT and 53% in patients with persistently inducible 'nonclinical' arrhythmias (P

AB - Background: Radiofrequency (RF) catheter ablation is effective therapy for monomorphic ventricular tachycardia (VT) in patients without structural heart disease. In patients with postinfarction VT; however, this procedure has been used predominantly as adjunctive therapy, targeting only the patient's clinically documented arrhythmia. By targeting all inducible, sustained VT morphologies, we sought to determine the utility of RF catheter ablation as a primary cure in patients who present with hemodynamically tolerated VT. Methods and Results: RF ablation was attempted in 35 patients with a previous myocardial infarction and recurrent, hemodynamically tolerated VT. A mean of 3.9±2.7 VTs were induced per patient (range, 1 to 10). The clinically documented arrhythmia was successfully ablated in 30 of 35 patients (86%), and on follow-up electrophysiological testing, 11 patients had no inducible VT and were discharged without other therapy. Nineteen patients had inducible 'nonclinical' arrhythmias on follow-up testing, and the majority underwent cardiac defibrillator implantation. Freedom from recurrent arrhythmias, including sudden death, was 91% in patients without inducible VT and 53% in patients with persistently inducible 'nonclinical' arrhythmias (P

KW - Catheter ablation

KW - Coronary disease

KW - Tachyarrhythmias

KW - Tachycardia

UR - http://www.scopus.com/inward/record.url?scp=0030827580&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030827580&partnerID=8YFLogxK

M3 - Article

C2 - 9396447

AN - SCOPUS:0030827580

VL - 96

SP - 3499

EP - 3508

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 10

ER -