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Anatol J Cardiol. 2019 Mar;21(4):187-195. doi: 10.14744/AnatolJCardiol.2018.58534.

Endo/epicardial ablation of ventricular arrhythmias with contact force-sensing catheters in arrhythmogenic right ventricular dysplasia/cardiomyopathy.

Author information

1
Department of Cardiology, Türkiye Yüksek İhtisas Training and Research Hospital; Ankara-Turkey.

Abstract

OBJECTIVE:

To control ventricular arrhythmia in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), ablation may be required both from the endocardial and epicardial side. In this study, we analyzed the results of contact force-sensing (CFS) catheters in the endo/epicardial ablation of ventricular arrhythmias in ARVD/C.

METHODS:

We included 17 patients with ARVD/C, 5 of whom had premature ventricular contractions (PVC), and the rest of them were admitted with a ventricular tachycardia (VT) storm, between September 2014 and October 2016. We divided patients into two groups: the PVC and VT groups. Irrigated CFS catheters (Smart Touch, Biosense Webster, Inc.) were utilized in all procedures.

RESULTS:

In the PVC group, the mean ratio of PVC during the 24-hour Holter monitoring was 31.8+-7.6%. The mean contact force during mapping and ablation in the right ventricle was 13+-1.2 and 12.8+-1.9 grams, respectively. The mean follow-up duration was 15+-3.1 months for the PVC group. The left ventricular ejection fraction improved in all patients (52.8+-10%). All patients in the VT group underwent endo/epicardial ablation, except one. The mean contact force during the endocardium and epicardium mapping was 12.5+-1.2 and 12.5+-4.6 grams, respectively. The mean contact force during ablation for the endocardium and epicardium was 12.1+-1.4 and 12.8+-1.9 grams, respectively. All clinical and non-clinical VTs were ablated successfully, except in 2 patients who still had non-clinical VTs. The mean follow-up was 15.5+-4.5 months. None of the VT patients experienced electrical storm or death. Two patients had single shock, and 1 patient had two shocks during the follow-up.

CONCLUSION:

Endo/epicardial ablation of ventricular arrhythmias with CFS catheters in ARVD/C seems to be promising.

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