Key result
High-energy DC catheter ablation terminates refractory incessant VT in ~82% of patients.
Why the study?
Catheter ablation using high energy DC shock for incessant VT refractory to drugs and cardioversion has limited early and long-term outcome data.
Observational (n=11)
High-energy DC ablation may acutely terminate refractory incessant VT; leaves open long-term durability and safety versus modern techniques.
Catheter ablation of sustained monomorphic ventricular tachycardia (VT) with high energy DC shock (360-400 J) was performed in 11 patients with incessant VT (duration greater than 24 hours), refractory to antiarrhythmic drugs, and DC cardioversion. There were ten patients with coronary disease and one patient had dilated cardiomyopathy. Direct current energy was delivered at the earliest endocardial activation in six patients (group I) or at the area of slow conduction in five patients (group II). Incessant VT was terminated by DC ablation in nine patients (82%). After the ablation procedure VT remained inducible in four patients in group I (67%) and in one patient (20%) in group II. Two patients in group II had to go to emergent surgery. During the mean follow-up of 31 +/- 26 (1-66) months nonfatal VT recurrences occurred in five patients in group I and in one patient in group II.
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Trappe et al. (1992) conducted an observational in Incessant ventricular tachycardia (n=11). Catheter ablation with high energy DC shock was evaluated on Termination of incessant VT. Catheter ablation with high energy DC shock terminated incessant ventricular tachycardia in 82% of patients refractory to antiarrhythmic drugs and DC cardioversion.
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