This was a multicentric retrospective study. ARVC patients who were subjected to RCA of tolerable MVT were included. The patients were selected from 10 tertiary centres across 5 countries, without an ICD before and 3 months after RCA, without syncope or electrical storm and with left ventricular fraction ≥50%. 65 ARVC patients (mean age 44.5 ± 13.2 years, 78% males) were subjected to RCA of MVT between 2003 and 2016. Clinical findings were palpitations in 51 patients (81%). One patient (2%) experienced > 1 clinical MVT. Clinical MVT (mean rate 185 ± 32 b.p.m.) were inducible in 50 patients (81%) during the ablation procedure. In 19 patients (29%), epicardial ablation was performed. In 42 patients (72%), complete acute success was accomplished. The patients were followed up to a median of 52.4 months (range 12.3-171.4). No deaths or cardiac arrest were observed. However, in 19(29%) patients, VT had recurred. Survival without VT recurrence was approximated at 88%, 80% and 68%, 12, 36, and 60 months after RCA respectively. It depended on the approach and the procedural outcome.
Fatal arrhythmias after radiofrequency catheter ablation (RCA) did not occur in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and tolerable MVT without a back-up of implantable cardioverter defibrillators (ICD). This study implies that RCA could be an alternative to ICD in some ARVC patients.