Analysis Of Radiofrequency Catheter Ablation For Idiopathic Right Ventricular Outflow Tract Arrhythmia

Objective The aim of this study was to clarify gender, age, and clinical feature of idiopathic right ventricular outflow tract ventricular arrhythmia (ventricular tachycardia, ventricular premature contraction) with systematic retrospective analysis. To investigate the efficacy and safety of radiofrequency catheter ablation(RFCA) guided by routine mapping or CARTO mapping on idiopathic ventricular arrhythmia originating in right ventricular outflow tract. The study was designed to further improve the success rate of surgery, reduce the recurrence rate to provide clues.Methods From December 1999 to December 2009, RFCA was performed in 145 patients (55 males and 90 females) guided with ventricular arrhythmia originating in right ventricular outflow tract. Guided by CARTO mapping, RFCA was performed in 54 patients (20 males and 34 females) with idiopathic ventricular arrhythmia originating in right ventricular outflow tract. Guided by routine mapping, RFCA was performed in 91 patients (35 males and 56 females) with idiopathic ventricular arrhythmia originating in right ventricular outflow tract. The mapping time, ablation time, the success rate, recurrence rate, fluoroscopic time and the total procedure time were compared between the routine mapping group and CARTO mapping group.Results Of 145 patients,90 patients (62.1%) were female,55 patients (37.9%) were male, female/male ratio was 1.63.The early onset of symptom was at (41.2±12.7) years for female, and (37.6±15.0) years for male (P<0.05).Guided by CARTO mapping, the successful ablation sites were localized in septum in 43 patients, and in free wall in 11 patients. RFCA was successful in 51 patients (96.2%). After the follow-up of 11.3±7 months, no recurrence was observed. Guided by routine mapping, the successful ablation sites were localized in septum in 74patients, and in free wall in 17 patients. RFCA was successful in 84 patients (92.3%). After the follow-up of 35.4±9.8 months,9 patients relapsed and were all successfully re-ablated. Comparing the CARTO mapping group with the routine mapping group, the recurrence rate was statistically significant (P< 0.05). In CARTO mapping group, the mapping time, fluoroscopic time and the total procedure time of RFCA were shorter than those in routine mapping group(P<0.05).Conclusion Idiopathic right ventricular outflow tract arrhythmia occur more in female than in male, the early onset of symptom is older for female than for male. Radiofrequency catheter ablation (RFCA) is an effective safe and feasible treatment for patients' idiopathic right ventricular outflow tract ventricular arrhythmia with severe symptoms and drug-resistant. Comparing with routine mapping, CARTO mapping and ablation for ventricular arrhythmia originating in right ventricular outflow tract can decrease the recurrence.