Interv Akut Kardiol. 2009;8(5):228-232

Spectrum of the idiopathic ventricular tachycardias in specialized center

Markéta Koželuhová, Petr Peichl, Peter Hlivák, Robert Čihák, Dan Wichterle, Vladislav Vančura, Jan Bytešník, Josef Kautzner

Klinika kardiologie, Institut klinické a experimentální medicíny, Praha

Idiopathic ventricular tachycardias (VTs) appear in patients with no structural heart disease. The aim of our study was to describe allotment

of individual forms of idiopathic VTs in the cohort of the patients reported for treatment to the specialized center and describe the

possibilities of catheter ablation.

Methods: The study included 77 patients with idiopathic VT or ventricular ectopic beats (40 males, 37 females; age 49.5 ± 15.6 years,

ejection fraction of left ventricle 57.4 ± 3.8 %). Catheter ablation was performed under the guidance of activation sequence mapping,

electroanatomic mapping and intracardial echocardiography.

Results: Idiopathic VT was removed in 84 % after the first and in 13 % after the second procedure. There were no complications during the

procedures. In 36 patients (47 %) the arrhythmia originated from the right ventricular outflow tract, 6 arrhythmias (7.8 %) originated

from the endocard of the left ventricular outflow tract. In 8 patients the focus originated from the aortic cusps (10.4 %), 9 times the localization

was epicardial (11.7 %), twice in aortomitral continuity (2.6 %). In 3 patients the focus was in the basal region of he left ventricle

but outside the aortomitral continuity, 3 times deep in the interventricular septum (3.9 %). In 5 cases the tachycardia originated in the

conduction system (6.5 %) and in 5 patients there was no predilection. During the follow up (20.9 ± 10.4 months) there were recorded

no VTs or symptomatic ventricular extrasystoli in 58 patients (75 %), in 12 patients the procedure must have been repeated.

Conclusions: Spectrum of the idiopathic VTs is substantial; their origin can be analyzed by the 12-leads ECG. The catheter ablation in

specialized center is indicated in symptomatic patients or in the ones with cardiomyopathy induced by tachycardia.

Keywords: idiopathic ventricular tachycardia, substantial spectrum, 12-leads ECG, catheter ablation.

Published: November 20, 2009  Show citation