Electrode catheter ablation of resistant ventricular tachycardia in arrhythmogenic right ventricular dysplasia: experience of 15 patients with a mean follow-up of 45 months.

Fulguration (electrode catheter ablation) is a new method used for the radical treatment of ventricular tachycardia that may permanently alter the arrhythmogenic substrate preventing arrhythmia relapses. This form of therapy should be considered when drugs are proven ineffective or produce intolerable side effects and in noncompliant or young, active patients where long-term drug therapy might be undesirable. Fulguration, which uses the effects of a strong electrical shock delivered at the tip of an endocardial catheter positioned in the area to be modified, is an ablative technique whose usefulness for interruption of normal atrioventricular (AV) conduction has been extensively explored for the indirect treatment of supraventricular tachycardia [1, 2]. The same electrical energy applied directly on the site of origin of abnormal ventricular activation, as determined by endocardial mapping, in the treatment of chronic ventricular tachycardia is a more recent and promising development [3-5]. We have been involved in the evaluation of this new form of therapy with a total series of 59 consecutive cases.