Electrocardiographic Predictors of Failure and Recurrence in Patients with Idiopathic Right Ventricular Outflow Tract Tachycardia and Ectopy Who Underwent Radiofrequency Catheter Ablation

Marivic Vestal, Ming Shien Wen, San Jou Yeh, Chun Chieh Wang, Fun Chung Lin, Delon Wu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

41 Scopus citations

Abstract

This study reports new electrocardiographic (ECG) predictors of radiofrequency catheter ablation failure and recurrence in idiopathic right ventricular outflow tract (RVOT) ventricular tachycardia (VT) or ectopy based on 91 consecutive patients. Procedural success and failure rates were 85% (77/91) and 15% (14/91), respectively. Twenty three percent (18/77) had recurrence during the follow-up period of 1 to 120 months (mean 56 ± 31 months). Baseline RVOT VT/ectopy on 12-lead ECG taken prior to ablation from 91 patients were retrospectively analyzed. Ablation performed with RVOT ectopy (isolated ectopies, bigeminy, trigeminy, or couplets) as template arrhythmia was more likely to fail (30% vs. 8%, P = .02) as opposed to RVOT VT (sustained or nonsustained). VT/ectopy-QRS morphology variation was more observed in failed ablations (36% vs. 7%, P = .001). Significantly wider mean VT/ectopy QRS in leads I, II, AVR, V2, V3, V5, and V6 were noted in failed ablation group. Mean R wave amplitude reached statistical significance only in lead II (22.0 ± 5.1 mV for failed vs. 17.8 ± 5.2 mV for successful outcomes; P = .009). QRS morphologic variation (47% vs. 16%; P = .009) was the only statistically significant ECG to be more common in patients with arrhythmia recurrence. In conclusion, ablation with ectopy over VT as template arrhythmia, presence of QRS morphologic variation, wider mean QRS width, and taller mean R-wave amplitude in lead II were identified ECG predictors of failed RVOT VT/Ectopy ablation. The only ECG predictor of recurrence was the presence of RVOT VT or ectopy QRS morphologic variation.

Original languageEnglish
Pages (from-to)327-332
Number of pages6
JournalJournal of Electrocardiology
Volume36
Issue number4
DOIs
StatePublished - 10 2003

Keywords

  • Radiofrequency catheter ablation
  • Ventricular tachycardia

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