Australian and New Zealand journal of medicine
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Clinical Trial
Idiopathic right ventricular tachycardia: electrophysiology and response to catheter ablation.
Ventricular tachycardia (VT) originating in the right ventricle may be seen in the absence of structural heart disease. Although this is thought to be associated with a benign course, it may cause intolerable symptoms and be difficult to control with antiarrhythmic drugs. ⋯ Five patients had successful ablation of the tachycardia focus with long term suppression of the arrhythmia. Patients with successful ablation were characterised by inability to induce VT with extrastimuli, a distinct VT morphology with a rS pattern in lead 1, right axis deviation, facilitation of VT with isoprenaline and site of origin in the lateral outflow tract. During VT, an earlier site of presystolic activation was found in successful patients compared with unsuccessful ablations. Right ventricular tachycardia in patients without structural heart disease is a heterogeneous disorder with varied clinical and electrophysiologic features. Successful ablation of VT may be predicted by consideration of these variables.