Precordial QRS amplitude ratio predicts long-term outcome after catheter ablation of electrical storm due to ventricular tachycardias in patients with arrhythmogenic right ventricular cardiomyopathy

- Precordial-QRS Amplitude ratio (∑ QRSmvV1-V3/∑ QRSmvV1-V6) a simple ECG criterion, is an independent predictor of outcome after catheter ablation of ventricular tachycardia in patients with arrhythmogenic right ventricular cardiomyopathy.
- A ratio ≤ 0.48 (OR: 4.8; 95% CI: 1.1-22.3, P = 0.019) which could represent more extensive RV degenerative changes, is independently associated with VT recurrence during follow up.

BackgroundRadiofrequency catheter ablation is currently considered as the therapeutic option of choice in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and recurrent ventricular tachycardia (VT).MethodsThis study intended to assess the long-term outcome of catheter ablation in patients with ARVC and electrical storm. The specific objective was to assess the relationship between precordial QRS amplitude ratio and outcome of catheter ablation in these patients.ResultsTwenty-eight patients (19 men, age 52.3 ± 14.2 years) underwent 48 catheter ablation procedures (range 1-6, six epicardial). During a mean follow-up of 18.7 ± 15.1 months, 13 patients (46.5%) experienced VT recurrence. Age > 50 years and ∑ QRSmvV1-V3/∑ QRSmvV1-V6 ≤ 0.48 but not right ventricular size and acute ablation outcome were associated with VT recurrence during the follow up.ConclusionAge > 50 years and ∑ QRSmvV1-V3/∑ QRSmvV1-V6 ≤ 0.48 predict recurrence of VT after successful radiofrequency catheter ablation of VT in patients with ARVC and electrical storm.