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Question:

Is ablation a good choice for arrhythmias associated with the right ventricular outflow tract (RVOT)?

I have a long history of PVCs, NSVT, 30 beat run of slow VT, and feelings of shortness of breath and dizziness. I also have diastolic dysfunction grade 1 with high blood pressure, and I am a 65 year old female. My EF was 55 to 60 last year down to 50. I had an angiogram to rule out blockages. Very minimal CAD.  Doctor that did angiogram said wished he had my arteries. Everything pointed to a healthy heart. However, my 48 hour Holter consistently points to over 22 to 28% PVCs , NSVT, and 166 VT runs but heart rate only up to 150.  My father had an arrhythmia and had a pacemaker at 54 in 1974. He died suddenly of acute heart failure. Doctors here are talking ablation for possible RVOT [right ventricular outflow tract] ablation? I am reading this is not life-threatening, just very life-changing with symptoms. What do your doctors feel about ablations for this situation?  

submitted by Sandra from Cincinnati, Ohio on 1/27/2013

Answer:

by Texas Heart Institute cardiologist, Mohammad Saeed, MD    

Mohammad Saeed, MDPVCs [premature ventricular contractions] or VT [ventricular tachycardia] arising from outflow tract are generally benign and occur in people with otherwise normal hearts. They usually require treatment if they are very frequent or causing symptoms. Treatment options involve drug therapy with an anti-arrhythmic medication (like flecainide or sotalol) versus catheter ablation. Both options are good. In your case if there is a concern that frequent VT is causing a decrease in ejection fraction (EF) then catheter ablation would be preferable.

Overall, success of ablation depends upon the expertise and experience of the operator. It is a very safe and effective procedure.     

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Updated January 2013
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Texas Heart Institute Heart Information Center
Through this community outreach program, staff members of the Texas Heart Institute (THI) provide educational information related to the prevention, diagnosis, and treatment of cardiovascular disease. It is not the intention of THI to provide specific medical advice, but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided and THI urges you to visit a qualified physician for diagnosis and for answers to your questions.
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