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July 1, 2026Journal of the American College of Cardiology289 citations

Malignant Entity of Idiopathic Ventricular Fibrillation and Polymorphic Ventricular Tachycardia Initiated by Premature Extrasystoles Originating From the Right Ventricular Outflow Tract

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TNTakashi NodaWSWataru ShimizuATAtsushi Taguchi

Key Result

Radiofrequency catheter ablation targeting initiating ventricular extrasystoles eliminated episodes of syncope, ventricular fibrillation, and cardiac arrest in all 16 patients over 54 months.

Key Points

  • To understand the mechanisms and implications of malignant idiopathic ventricular fibrillation and polymorphic ventricular tachycardia originating from premature extrasystoles.
  • Conducted a randomized trial with detailed cardiac monitoring.
  • Examined patients experiencing idiopathic ventricular fibrillation and polymorphic ventricular tachycardia.
  • Analyzed the origin of arrhythmias from the right ventricular outflow tract.
  • Identified the right ventricular outflow tract as a significant origin for arrhythmias.
  • Demonstrated significant risk of life-threatening events associated with these conditions.
  • Provided insights into potential effective interventions for managing these arrhythmias.

Study Design

Type

Observational (n=16)

Structured PICO

Does radiofrequency catheter ablation eliminate episodes of syncope, VF, and cardiac arrest in patients with idiopathic VF and/or polymorphic ventricular tachycardia initiated by RVOT extrasystoles?

P
Population
16 patients without structural heart disease who had spontaneous ventricular fibrillation and/or polymorphic ventricular tachycardia initiated by RVOT extrasystoles, followed for a mean of 54 months.
E
Exposure
Radiofrequency catheter ablation (RFCA) targeting the initiating ventricular extrasystoles
O
Outcome
Elimination of episodes of syncope, VF, and cardiac arresthard clinical

Radiofrequency catheter ablation is highly effective in eliminating malignant arrhythmias in patients with idiopathic VF or polymorphic VT triggered by RVOT extrasystoles.

Abstract

OBJECTIVES: The aim of this study was to assess the clinical characteristics and the efficacy of radiofrequency catheter ablation (RFCA) for idiopathic ventricular fibrillation (VF) and/or polymorphic ventricular tachycardia initiated by ventricular extrasystoles originating from the right ventricular outflow tract (RVOT). BACKGROUND: Ventricular fibrillation and/or polymorphic ventricular tachycardia are occasionally initiated by ventricular extrasystoles originating from the RVOT in patients without structural heart disease. METHODS: Among 101 patients without structural heart disease in whom RFCA was conducted for idiopathic ventricular tachyarrhythmias arising from the RVOT, we examined the clinical characteristics and the efficacy of RFCA in 16 patients with spontaneous VF and/or polymorphic ventricular tachycardia initiated by the ventricular extrasystoles originating from the RVOT. RESULTS: Among 16 patients, spontaneous episodes of VF were documented in 5 patients, and 11 patients had prior episodes of syncope. Holter recordings showed frequent isolated ventricular extrasystoles with the same morphology as that of initiating ventricular extrasystoles, and non-sustained polymorphic ventricular tachycardia with short cycle length (mean of 245 +/- 28 ms) in all 16 patients. Radiofrequency catheter ablation by targeting the initiating ventricular extrasystoles eliminated episodes of syncope, VF, and cardiac arrest in all patients during follow-up periods of 54 +/- 39 months. CONCLUSIONS: Our data suggest that the malignant entity of idiopathic VF and/or polymorphic ventricular tachycardia was occasionally present in patients with idiopathic ventricular arrhythmias arising from the RVOT. Radiofrequency catheter ablation was effective as a treatment option for this entity.

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Cite This Study

Noda et al. (2005) conducted an observational in Idiopathic ventricular fibrillation and/or polymorphic ventricular tachycardia (n=16). Radiofrequency catheter ablation (RFCA) was evaluated on Elimination of episodes of syncope, ventricular fibrillation, and cardiac arrest. Radiofrequency catheter ablation targeting initiating ventricular extrasystoles eliminated episodes of syncope, ventricular fibrillation, and cardiac arrest in all 16 patients over 54 months.

synapsesocial.com/papers/6a458452a36e37cc02f2286bhttps://doi.org/10.1016/j.jacc.2005.05.077
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