Single-centre experience with an 8-mm tip catheter for radiofrequency catheter ablation of outflow tract ventricular ectopic beats

Arch Cardiovasc Dis. 2012 Jan;105(1):24-32. doi: 10.1016/j.acvd.2011.11.006. Epub 2012 Feb 9.

Abstract

Background: Radiofrequency ablation (RFA) of outflow tract ventricular ectopic beats (OTVEBs) can be performed using a 4-mm or externally-cooled tip RFA catheter, but no data are available concerning the safety and efficacy of a large-tip (8-mm) catheter.

Aims: To evaluate the feasibility of using an 8-mm tip catheter in patients with OTVEBs.

Methods: In this prospective cohort study, the 8-mm tip catheter was tested in patients who were referred to our centre for RFA of symptomatic OTVEBs.

Results: The mean age of the 16 patients recruited between September 2008 and March 2010 was 53±18 years and 56.3% were male. Mean left ventricular ejection fraction was 62±9%, mean ventricular ectopic beat width was 144±21 ms, and all patients had left bundle branch block. Fourteen patients had inferior axis QRS morphology and two had superior. The main symptoms were palpitations and pre-syncope. RFA parameters were: procedure time 94±35 min; duration of application 11±10 min; impedance 81±12 Ω; temperature 50±5 °C; and power 46±17 W. RFA succeeded in 15 over 16 patients (93.8%); and recurrence was seen in one patient after a mean follow-up time of 11±6 months. No complications were noted.

Conclusions: This preliminary study suggests that an 8-mm tip catheter may represent an alternative for RFA in patients with OTVEBs in whom a 4-mm tip was not successful. Larger randomized studies are therefore warranted.

Publication types

  • Comparative Study

MeSH terms

  • Catheter Ablation / instrumentation*
  • Catheters*
  • Echocardiography
  • Electrocardiography
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Heart Conduction System / physiopathology
  • Heart Conduction System / surgery*
  • Humans
  • Magnetic Resonance Imaging, Cine
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Ventricular Function, Left
  • Ventricular Premature Complexes / diagnosis
  • Ventricular Premature Complexes / physiopathology
  • Ventricular Premature Complexes / surgery*