Long-lasting Ventricular Fibrillation in Humans ECG Characteristics and Effect of Radio-frequency Ablation.

Maury, Philippe; Duchateau, Josselin; Rollin, Anne; Hocini, Mélèze; Voglimacci-Stephanopoli, Quentin; Monteil, Benjamin; Sacher, Frederic; Jaïs, Pierre; Bernus, Olivier; Mondoly, Pierre; Delmas, Clément; Haïssaguerre, Michel; Dubois, Rémi

Background - Studies of ventricular fibrillation (VF) in humans are limited because of the short available duration. We sought to study surface ECG waveforms and effect of ablation in long-lasting VF in patients with left assist devices. Methods - Continuous 12 lead-ECG of 5 episodes of long-lasting VF occurring in 3 patients with left ventricular assist device were analyzed. Spectral analysis (dominant frequency, DF) and quantification of waveform amplitude, regularity (URI) and complexity (NDI) were performed over a median of 24 minutes of VF. RF ablation was performed during VF in two patients. Results - There was a significant increase in DF between VF onset and termination but none of the other parameters significantly changed. Some VF parameters varied from patient to patient and from lead to lead. DF decreased after RF ablation in both cases and VF terminated spontaneously shortly after ablation in one case. The previously incessant VFs in these two patients did not recur afterward. Conclusions - VF rate increases over time in patients with left ventricular assist devices and is lowered by ablation. Long-lasting VF may be modified or even terminated by ablation.