LAUSR

BACKGROUND Prior studies of radiofrequency catheter ablation (RFA) of ventricular tachycardia (VT) in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients, relying on limited numbers of procedures, have not reported VT-free survival in parallel for single and multiple procedures (i.e., after the last procedure). Additionally, there is a scarcity of data regarding the impact of RFA on VT burden. OBJECTIVES To provide new insights regarding clinical outcomes based on a large series of VT ablation procedures from the current era in ARVC patients METHODS: We evaluated consecutive patients with definite ARVC who underwent RFA procedures between 2009 and 2019 at our center. We assessed VT-free survival, for single and multiple procedures, and changes in VT burden and anti-arrhythmic drugs (AADs) after RFA. RESULTS Among 116 patients, there were 166 RFA procedures, 106 (63.9%) of which involved epicardial ablation. Cumulative freedom from VT after a single procedure was 68.6% and 49.8% at 1 and 5 years. Cumulative VT-free survival after multiple procedures was 81.8% and 69.6% at 1 and 5 years. VT burden per RFA was reduced after vs. before ablation (mean: 0.7 vs. 10.0 events/year, p<0.001). Further, VT burden per patient was reduced after last ablation vs. before first ablation (mean: 0.5 vs. 10.9 events/year, p<0.001). Use of AADs decreased after ablation (22.2% vs. 51.9%, p<0.001). CONCLUSIONS In ARVC patients, RFA provided good VT-free survival after a single procedure, with multiple procedures required for more sustained freedom from VT recurrence. Importantly, there was marked reduction in VT burden, permitting discontinuation of AADs.