ventricular complexes (PVCs) and ventricular tachycardia (VT) in patients with
structurally normal hearts originate from the right ventricular outflow tract
(RVOT) in the majority of cases. In the last few decades catheter ablation of
these arrhythmias has been proven to be effective. RVOT VT/PVCs may cause
disabling symptoms or arrhythmia induced cardiomyopathy. However, the PVC
burden at which catheter ablation should be recommended is still controversial.
What adds to the controversy is why some patients with only a low number of PVCs
can be highly symptomatic and may even develop arrhythmia induced
cardiomyopathy, whilst others may have a higher PVC/VT burden and remain
asymptomatic and do not develop cardiomyopathy for a long period of time.
Therefore, although catheter ablation of RVOT PVCs has high success and low
complication rates, the time point of when ablation should be recommended is
currently still under debate. This review discusses the treatment strategies
and prognosis for RVOT tachycardias and focuses on the question of which
arrhythmia burden is appropriate to offer RF ablation.
Credits: Andreas Rillig; Tina Lin; Feifan Ouyang; Karl-Heinz Kuck; Roland Richard Tilz