Long-term outcome of catheter ablation for left posterior fascicular ventricular tachycardia with the development of left posterior fascicular block and characteristics of repeat procedures.
OBJECTIVE
The present study aimed to retrospectively investigate long-term clinical outcomes of patients undergoing catheter ablation of left posterior fascicular ventricular tachycardia (LPF-VT) with the development of left posterior fascicular block (LPF block) and characteristics of repeat procedures.


METHODS AND RESULTS
A total of 195 patients (mean age 29.76±1.03years, 16.4% females) who underwent catheter ablation for LPF-VT were consecutively enrolled. The earliest ventricular potential with a single fused Purkinje potential (PP) during VT and the PP located in the inferior-apical or mid-apical septum during SR were targeted for linear ablation. The endpoint of the procedure was noninducible VT and development of new-onset LPF block. Follow-up with clinic visits or telephonic interviews, electrocardiogram (ECG), or Holter monitoring was performed after the procedure. With a median follow-up of 85 (18,181) months, 20 patients were censored and 152 of 175 (86.86%) patients had long-term freedom from VT after a single procedure. No statistical difference in the outcome of catheter ablation of LPF-VT was found between inducible and non-inducible groups (P=0.89). Twenty-three patients exhibited recurrent LPF-VT. Seven of 23 patients developed new-onset left upper septal ventricular tachycardia that was successfully ablated. All the patients undergoing repeat procedures had freedom from VT. No procedural complications occurred.


CONCLUSIONS
Ablation of LPF-VT using the development of LPF block as the endpoint is associated with a high procedural success rate. No difference in freedom from LPF-VT was found between inducible and non-inducible patients. New-onset LPF block recovery and non-early PP-QRS interval can be the predictors of LPF-VT repeat procedure.
['Luo|Bin|B|', 'Zhou|Gongbu|G|', 'Guo|Xiaogang|X|', 'Liu|Xu|X|', 'Yang|Jiandu|J|', 'Sun|Qi|Q|', 'Ma|Jian|J|', 'Zhang|Shu|S|']
D000293:Adolescent D000328:Adult D002037:Bundle-Branch Block D017115:Catheter Ablation D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D012008:Recurrence D012189:Retrospective Studies D017180:Tachycardia, Ventricular D013997:Time Factors D016896:Treatment Outcome D055815:Young Adult
Catheter ablation Left posterior fascicular ventricular tachycardia Left posterior fascicular block Repeat procedure