Efficacy of Fixed Low‐Power Long‐Duration Radiofrequency Ablation of Ventricular Arrhythmias Originating From the Left Ventricular Summit

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ABSTRACT Background Radiofrequency catheter ablation (RFCA) of ventricular arrhythmias originating from the left ventricular summit (LVS‐VAs) remains challenging. Objective The present study aimed to assess the efficacy and safety of endocardial fixed low‐power long‐duration RFCA (LPLD RFCA), compared with conventional RFCA in the treatment of LVS‐VAs. Methods We retrospectively analyzed data from 47 patients with LVS‐VAs: 17 underwent LPLD RFCA defined as RF delivery at a fixed power of 20 W or 25 W for 120–180 s, and 30 received conventional RFCA. Procedural outcomes, complications, and follow‐up data were compared. Results The LPLD RFCA group had significantly lower mean RF power and a longer total application time compared to the conventional group (20 ± 1.0 W vs. 36 ± 5.4 W, and 30 ± 13 min vs. 15 ± 11 min, respectively; both p < 0.01). Acute procedural success was achieved in 15 of the 17 patients (88%) in the LPLD RFCA group and in 17 of the 30 patients (56%) in the conventional RFCA group ( p < 0.05). No major complications, including steam pops or pericardial effusion, occurred in either group. The long‐term efficacy of the fixed LPLD RFCA was maintained during the 16‐month follow‐up. Conclusions Endocardial RFCA using a fixed LPLD RFCA strategy was associated with a higher acute success rate without major complications compared with conventional RFCA in patients with LVS‐VAs. This approach may represent a feasible alternative ablation strategy for LVS‐VAs.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.