Arrhythmias & electrophysiology
Ablation of ventricular tachycardia from right ventricular aneurysms in patients with arrhythmogenic cardiomyopathy guided by intracardiac echocardiography
Authors' conclusion
Endocardial ablation targeting VT from ICE-defined RV free wall aneurysms in ARVC patients using prolonged radiofrequency applications is safe and effective, precluding the need for adjunctive epicardial ablation. Patients with aneurysm-dependent VT were typically older and carried pathogenic genetic variants.
Study context
- Population
- ARVC patients with VT mapped to intracardiac echocardiography (ICE)-defined RV free wall aneurysms who underwent endocardial ablation targeting the aneurysmal area, 2012 to 2023ARVC patients who underwent endocardial VT ablation within ICE-defined RV free wall aneurysms
- Participants
- 14 patients
- Outcome
- VT control, defined as freedom from any or multiple (>1) VT recurrences
- Follow-up
- Median 4.3 years (IQR, 3.1-6.0 years)
Main finding
As reported in the abstract
Primary end point achieved
13 patients
93%
VT free
10
Single episode of VT
3
Further findings
Median age at first arrhythmia event
- Median age at first arrhythmia event
- 55.5 years (interquartile range [IQR], 32.3-59.8 years)
Pathogenic genetic variants
- Pathogenic genetic variants identified
- 82%
Radiofrequency application duration and power
- Radiofrequency application duration
- median, 111 seconds; IQR, 81-180 seconds
- Power titrated up to
- 29 W (IQR, 29-33 W)
- Target impedance drops
- 10%-15%
VT noninducibility
- VT noninducibility achieved
- 86%
Safety
- No steam pops occurred
- No complications
Original publication
Ablation of ventricular tachycardia from right ventricular aneurysms in patients with arrhythmogenic cardiomyopathy guided by intracardiac echocardiography. Heart Rhythm. Published 3 February 2025. doi:10.
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