202 Feasibility, safety and efficacy of 8mm-tip catheter for radiofrequency catheter ablation of outflow tract ventricular ectopic beats

BackgroundRadiofrequency ablation [RFA] of outflow tract ventricular ectopic beats [OTVEBs] can be performed using either a 4mm or an externally-cooled tip RFA catheter but not data are available concerning the safety and the efficacy with a large-tip [8mm] catheter. However, experimental and clinical studies suggest that the efficacy of catheters may vary mainly with several parameters including catheter tip, cooling effect, anatomy and catheters orientation. We hypothesized that an 8mm tip catheter can be safely used in patients with OTVEBs.ObjectivesThe aim of this prospective study was to evaluate the safety and the efficacy of an 8mm tip catheter in patients with OTVEBs.Method and ResultsBetween September 2008 and March 2010, 17 patients were referred for RFA of symptomatic OTVEBs and 2 patients were excluded [1 cardiomyopathy and 1 due to the vicinity of His bundle]. In a primary intent the 8mm tip catheter was tested. Population characteristics were as follows: mean age of 51±17 years; 46.7% female; LVEF (55±8%); VEB morphology [100% LBBB], axis [13 inferior and 2 superior], major symptoms [palpitations in 7, pre-syncope in 6, syncope in 1, and dyspnea in 1], VEB width 144±21ms, and number of drug failure [2.2±0.5]. RFA succeeded in 14/15 patients [93.3%] and RFA parameters were: procedure time [94±35min], duration of application [11±10min], impedance [81±12], temperature [48±5 degree] and power [46±17 watts]. In one patient RFA failed. Recurrence occurred in 1/15 patients [6.6%] with a mean follow-up of 8±6 months. No complication was observed.ConclusionsThis study demonstrated the feasibility, safety and efficacy of a strategy with an 8mm tip RFA catheter to cure patients with outflow tract ventricular ectopic beats