Feasibility and complication prevention of radiofrequency catheter ablation with electrophysiology in treatment of ventricular arrhythmia

Fang Zhe; Zhang Xinyong; Yu Ronghui; Liu Yuyang; Li Yueping; Wang Pengfei; Wang Rui; Li Yang; Ma Xiuhua; Dong Jianzeng; Zhou Yujie

doi:10.3760/cma.j.issn.1673-4777.2017.05.015

Abstract：Objective To investigate the feasibility and safety of radiofrequency ablation treating frequent ventricular premature beat (VPB) and ventricular tachycardia (VT).Methods From December 2015 to December 2016,11 cases of frequent VPB/VT who had radiofrequency ablation in Beijing Anzhen Hospital,Capital Medical University were enrolled.According to manifestations of V1 and V2 leads in electrocardiogram,the patients were divided into right side treatment group (8 cases) and left side treatment group (3 cases).Three-dimensional composition of VPB/VT outflow tract was established to analyze electrophysiological features of ablation targets.Ablation targets showed early excitation of surface bipolar QRS wave(more than 20 ms earlier compared to the QRS wave in surface electrocardiogram) and/or local unipolar QS wave,electric potential reversed;similarities of amplitude,shape,duration between pacing electrocardiogram and VPB/VT electrocardiogram were more than 11/12.Ablation success rate and incidence of complications were analyzed.Results VPB/VT originated from right pulmonary artery in 8 cases and originated from ascending aorta in 2 cases;1 case that was suspected originating from right pulmonary artery had ablation between left sinus and right sinus of ascending aorta.The ablation success rate was 100％ in all patients;no recurrence was observed in 3 months.The incidence of peripheral vessel complication and pericardial perforation in right side treatment group was significantly lower than that in left side treatment group(0/8 vs 1/3,P ＜ 0.05).Ablation catheter impedance and the distance from V1 lead QRS starting point had no significant differences between right side treatment group and left side treatment group [(160±23)Ω vs (165±18)Ω,(27±4)mm vs (30±5)mm](P＞0.05).Conclusion Electrophysiological radiofrequency ablation is safe and reliable for treating frequent VPB and VT.