Idiopathic Outflow Tract Ventricular Arrhythmia Ablation

Callans, David J.

doi:10.1161/circep.116.004537

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…Catheter ablation has been reported to have an acute procedural success rate of 80%‐90% for idiopathic VAs and up to 84 to >95% for the outflow tract ventricular arrhythmias (OT‐VAs) . One of the factors that limit the success of standard VA ablation is an origin of the arrhythmia from a deeper/inaccessible location within the myocardium . Thus, strategies to improve ablation lesion depth and transmurality continue to be explored .…”

Section: Introductionmentioning

confidence: 99%

Clinical efficacy of open‐irrigated electrode cooled with half‐normal saline for initially failed radiofrequency ablation of idiopathic outflow tract ventricular arrhythmias

Chung

Lin

et al. 2019

Cardiovasc electrophysiol

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Background Acute failure of radiofrequency ablation (RFA) of ventricular arrhythmias (VAs) occur in 10%‐20% of patients and is partly attributed to inadequate lesion depth acquired with standard ablation protocols. Half‐normal saline (HNS)‐irrigation is a promising strategy to improve the success rate of VA ablation. Objective This study investigated the efficacy of HNS‐irrigated ablation after a failed standard plain normal saline solution (PNSS)‐irrigated ablation on idiopathic outflow tract ventricular arrhythmia (OT‐VA). Method This is a prospective observational study of consecutive patients undergoing RFA of idiopathic OT‐VA comparing the efficacy of additional HNS‐irrigated ablation for failed standard PNSS‐irrigated ablation. Acute failure was defined as persistence of spontaneous VA or persistent inducibility of the clinical VA. Results Out of 160 OT‐VA cases (51 ± 15‐year‐old, 62 males), 31 underwent HNS irrigation after a failed standard PNSS‐irrigated ablation. The HNS group had a significantly longer procedure time (60.06 ± 43.83 vs 37.51 ± 33.40 minutes; P = .013) and higher radiation exposure (31.45 ± 20.24 vs 17.22 ± 15.25 minutes; P = .001) than the PNSS group but provided an additional acute success in 21 of 31 (67.7%) patients. Over a follow‐up duration of 7.8 ± 4.6 months, 24 recurrences were identified, including 8 (25.8%) in the HNS and 16 (12.4%) in the PNSS group, with lower freedom from recurrence in the HNS group (log rank P = .009). No major complication was observed. Conclusion HNS‐irrigated ablation after failed standard PNSS‐irrigated ablation is safe and additionally improves acute ablation success by 67.7% for idiopathic OT‐VA but with a higher rate of recurrence on follow‐up. Whether the application of HNS as initial irrigant could result in better outcome requires further investigation.

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Section: Introductionmentioning

confidence: 99%