Clinical characteristics and acute results of catheter ablation for outflow tract ventricular tachycardia or premature beats Suzanne D. A. Valk & Natasja M. S. de Groot & Tamas Szili-Torok & Yves L. E. Van Belle & Jan C. J. Res & Luc Jordaens Received: 19 March 2012 / Accepted: 6 June 2012 / Published online: 7 August 2012 # Springer Science+Business Media, LLC 2012 Abstract Purpose Contemporary outcome data of catheter ablation for outflow tract tachycardia (OTT) and ventricular prema- ture beats (VPBs) are rare. The aim of this study was to describe the clinical characteristics, the acute procedure success rate, and the long-term survival of patients who underwent an ablation procedure for OTT or VPBs. Methods The study was a single-center retrospective cohort study. All 82 consecutive OTT and VPB first ablation pro- cedures between 1999 and 2009 were included. Patients with structural heart disease were excluded. Results Mean age was 46±13 years. Forty-three percent of the patients were male. All patients were alive after a medi- an follow-up duration of 31 months (interquartile range, 14– 65 months). Eighty-nine percent suffered from palpitations and 12 % had a history of syncope. Ventricular tachycardia was documented in 73 % and monomorphic VPBs in 99 %. Seventy-three percent of the patients were ablated in the right ventricular outflow tract, 15 % in the left ventricular outflow tract, and 12 % in the coronary cusps. Radiofre- quency energy was used in 95 % of the patients, cryo energy in 9 %. Acute success was achieved in 78 %. Six patients (7 %) experienced a complication (five pericardial effusions, one pseudo-aneurysm of the femoral artery). Three patients needed pericardiocentesis (4 %). Conclusion Ablation for OTT and VPB is successful in the vast majority of cases, with a low but still existing compli- cation rate. Long-term survival was excellent, underscoring the benign nature of this arrhythmia. Keywords Outflow tract tachycardia . Ventricular premature beats . Catheter ablation . Acute success . Complications . Long-term survival 1 Introduction Ventricular tachycardia (VT) that occurs in the absence of detectable structural heart disease is called idiopathic VT. Idiopathic VT accounts for approximately 10 % of all patients who are referred for evaluation of VT [1]. The most common form of idiopathic VT is the outflow tract tachycardia (OTT). More than 80 % originate from the right ventricular outflow tract (RVOT). The remainder originate from the left ventricu- lar outflow tract (LVOT) or from the aortic coronary cusps. The disease entity is characterized by the occurrence of fre- quent ventricular premature beats (VPBs) or VT. The respon- sible mechanism is thought to be cAMP-mediated triggered activity with delayed after-depolarizations due to intracellular calcium overload [2]. The prognosis is assumed to be benign [3, 4]. There are, however, sporadic reports on (aborted) sudden cardiac death in patients who had previously been diagnosed with idiopathic VT [5, 6]. The treatment of choice has been anti-arrhythmic drug (AAD) therapy with beta- blockers, calcium channel blockers or class IC AAD. In recent years however, the focus has shifted from drug therapy to- wards invasive catheter ablation, mainly because AAD thera- py is effective in only 25–50 % of the patients, depending on S. D. A. Valk : N. M. S. de Groot : T. Szili-Torok : Y. L. E. Van Belle : J. C. J. Res : L. Jordaens (*) Department of Clinical Electrophysiology, Erasmus Medical Center, Rotterdam, The Netherlands e-mail: l.jordaens@erasmusmc.nl J Interv Card Electrophysiol (2012) 35:301–309 DOI 10.1007/s10840-012-9706-1