We conducted a study to assess the acute procedural success and the long-term effect of radiofrequency ablation (RFA) for ventricular tachycardia (VT) in patients with ischaemic heart disease.
We included 90 patients with ischaemic heart disease treated with RFA for VT in our institution. Data were obtained from patient files, and implantable cardioverter-defibrillator (ICD) discharges were recorded from in-house and remote follow-up data. Recurrence of VT during follow-up was noted as date of first ICD therapy for VT or first recurrence of symptomatic VT.
After the initial RFA procedure no VT was inducible in 42 patients (47%), non-clinical VT was inducible in 21 patients (23%), and the clinical VT was still inducible in 14 patients (16%). The procedural success was indefinable in 13 patients (14%). After a median follow-up of 33 months after the latest RFA, 38 patients (42%) stayed free from recurrent VT. The number of ICD shocks/year was significantly reduced from median 1.1 (interquartile range: 0.3-2.8) to 0 (0-0.4) (p
to study microvolt T-wave alternans (mTWA) and heart rate turbulence (HRT) in patients with hypertrophic cardiomyopathy (HCMP).
We examined 50 patients with HCMP: 15 (28%) with obstructive form, 23 (46%) with major risk factors of sudden cardiac death (SCD), 7 (14%) with left ventricular thickness more or equal 3 cm, 6 (12%) with family history of SCD, 16 (32%) with attacks of nonsustained ventricular tachycardia (NVT), 5 (10%) with episodes of syncope. Control group comparable by age and gender composition comprised 50 persons without cardiovascular diseases. All patients were subjected to 24-hour ECG monitoring with registration of parameters of variability and HRT (turbulence onset [TO], turbulence slope), maximal mTWA values, mTWA at heart rate 100 bpm, mTWA at 05.00 AM (mTWA05:00).
Patients with HCMP compared to controls were characterized by significantly higher values of mTWA05:00 (19 [13;30] and 9 [4;15] mcV, respectively, p
INTRODUCTION: The aim of this study was to investigate the age, sex, etiology, frequency of implantable cardioverter-defibrillator (ICD) and previous cardiac arrest among patients discharged from the Department of Cardiology, Rigshospitalet (Copenhagen University Hospital), Denmark, due to ventricular tachyarrhythmias. MATERIALS AND METHODS: We conducted a retrospective review of 993 patients discharged from Rigshospitalet over 6 years and 5 months with the diagnostic codes ventricular tachycardia, ventricular fibrillation or premature ventricular contractions. RESULTS: The population had an average age of 59 years (ranging 15-95 years) with a majority of males (76%). Among the patients with known etiology ischemic heart disease (60%), dilated cardiomyopathy (6%) and arrhythmogenic right ventricular cardiomyopathy (6%) were the most frequent. A substantial number of the patients (15%) had unknown etiology; 492 (50%) of the patients overall had an ICD implanted, the majority of whom had been categorized as having ventricular tachycardia (92%); 168 patients had previous cardiac arrest, 127 of whom did not have a potential reversible cause. Of this group 75 (59%) had an ICD implanted. CONCLUSION: Ischemic heart disease is the most common cause of ventricular tachyarrhythmias. Approximately half the patients admitted with ventricular tachyarrhythmias had an ICD implanted, the majority of whom did not have previous cardiac arrest.
