Outcomes of Catheter Ablation of Idiopathic Premature Ventricular Contractions Originating from Right Ventricular Outflow Tract: A Systematic Review and Meta-analysis

doi:10.21608/ejhm.2025.429386

Outcomes of Catheter Ablation of Idiopathic Premature Ventricular Contractions Originating from Right Ventricular Outflow Tract: A Systematic Review and Meta-analysis

Document Type : Original Article

10.21608/ejhm.2025.429386

Abstract

Background: Catheter ablation (CA) is an established first-line treatment for symptomatic idiopathic premature ventricular contractions (PVCs) or PVC-induced cardiomyopathy, particularly when PVCs originate from the right ventricular outflow tract (RVOT).
Objective: To perform a systematic review and meta-analysis evaluating acute and long-term outcomes of CA for idiopathic RVOT PVCs.
Patients and Methods: A comprehensive literature search was conducted across PubMed, Scopus, Embase, Cochrane, and ISI databases from 2000 to 2021. Inclusion criteria included English-language studies of ≥10 patients undergoing radiofrequency CA for monomorphic idiopathic RVOT PVCs, with documented short- and long-term outcomes. Studies involving structural heart disease or pleomorphic PVCs were excluded. Primary outcomes included acute success, complication rates, recurrence, and re-ablation.
Results: Of 512 identified records, six studies comprising 413 patients met the inclusion criteria. Acute success, defined as complete PVC suppression post-ablation (even with isoproterenol challenge), was achieved in 92% of patients. Complication and recurrence rates were low, at 3.3% and 10.8%, respectively, over a mean follow-up of 22.6 months. Repeat ablation was needed in only 4.27% of cases.
Conclusion: Radiofrequency ablation of idiopathic RVOT PVCs demonstrates high acute success and favourable long-term outcomes, with low complication and recurrence rates, supporting its safety and effectiveness as a primary therapeutic option.

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