Radiofrequency catheter ablation of multiple ventricular tachycardias

Objective To evaluate the safety and efficacy of radiofrequency catheter ablation(RFCA) guided by Ensite Array activation mapping or electroanatomic mapping(Carto) in patients with multiple ventricular tachycardias(VTs).Methods Thirteen patients with multiple VTs(8 males 5 females,aged 22-58 y)were enrolled.Of them,two with arrhythmogenic right ventricular cardiomypathy (ARVC),two with comary heart disease,one with long QT syndrome,and one with short QT syndrome.Catheter ablation was performed under the guidance of X-rays,high-frequency potentials,Carto system,and Ensite system.The targets were mapped with activation sequence,entrainment,and voltage mapping using standard criteria.Results Multiple VTs were induced in all patients, and 1 patients had clinically sustained VT during ablation.Mapping and ablation were performed under the guidance of Carto system in 6 patients,with the Ensite system in 2 patients and with pace map in the other 5.Two to six morphologies of VT were induced in 1 patients. There were 2 original locations in 9 cases,3 in 3 cases,and 4 in 1 case,separately.Two cases also had supaventriclar tachycardias in 2 cases VT originated from papillary muscle.In 10 patients multiple VTs were successfully abolished by radiofrequency ablation without any acute or chronic complications.Three patients failed,one with complication of RBBB.During follow-up of 1 to 48 months,VT recurred in 2 of 10 patients and VT episodes were reduced in the other 3 failed patients.Conclusions Some multiple VTs can be successfully cured by catheter ablation.The 3-dimentional mapping may be helpful in localizing the target site,which subsequently facilitates catheter ablation procedure.