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June 27, 2026EP EuropaceOpen Access

Anatomical high-power RF re-ablation safely achieves acute VA elimination in ~47% of previously failed cases.

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Why the study?

Does entirely anatomical high-power RF re-ablation safely and effectively eliminate ventricular arrhythmias in patients with refractory left ventricular summit arrhythmias?

Population

15 patients undergoing re-ablation for symptomatic, drug-refractory left ventricular summit arrhythmias…

Design

Cohort

Follow-up

14±9 months

Key result

Entirely anatomical high-power radiofrequency re-ablation achieved acute elimination of ventricular arrhythmias in 47% of patients with previously failed ablations, with no complications.

Authors

KSK SzkolaLZL ZarebskiMFM Futyma

Discussion

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Overview

Modest acute success in small Level 5 series warrants caution; leaves open efficacy and durability pending larger studies.

Key Points

  • The study aimed to assess the safety and effectiveness of high-power anatomical ablation in patients with refractory left ventricular summit arrhythmias following unsuccessful prior procedures.
  • Included consecutive patients undergoing re-ablation for symptomatic, drug-refractory LVS arrhythmias.
  • Utilized high-power (50-70W) anatomical ablation targeting the coronary cusps and subaortic LVOT.
  • Defined acute success as complete elimination of ventricular arrhythmias during ≥15 minutes of observation.
  • Acute PVC elimination achieved in 7 patients (47%).
  • No complications occurred during the procedures.
  • After 14±9 months follow-up, no recurrence of clinically relevant VA in all patients with successful re-ablation.

Study Design

Type

Observational (n=15)

Structured PICO

Does entirely anatomical high-power RF re-ablation safely and effectively eliminate ventricular arrhythmias in patients with refractory left ventricular summit arrhythmias?

P
Population
15 patients (mean age 56, 20% female) with symptomatic, drug-refractory left ventricular summit arrhythmias after prior failed ablations, followed for a mean of 14 months.
E
Exposure
Entirely anatomical high-power radiofrequency (RF) re-ablation (50-70W) from adjacent structures (coronary cusps, subaortic left ventricular outflow tract).
O
Outcome
Acute success defined as complete ventricular arrhythmia elimination during ≥15 minutes of observation, including salbutamol provocation.surrogate

Anatomical high-power RF re-ablation is safe and acutely effective in nearly half of patients with refractory left ventricular summit arrhythmias, though advanced strategies are often still required for the remainder.

Cite This Study

Szkola et al. (2026) conducted an observational in Symptomatic, drug-refractory left ventricular summit (LVS) arrhythmias after previously failed ablations (n=15). Entirely anatomical high-power radiofrequency (RF) re-ablation was evaluated on Acute success (complete VA elimination during ≥15 minutes of observation, including salbutamol provocation). Entirely anatomical high-power radiofrequency re-ablation achieved acute elimination of ventricular arrhythmias in 47% of patients with previously failed ablations, with no complications.

synapsesocial.com/papers/6a3f97e8125782b61d865ad3https://doi.org/10.1093/europace/euag105.1075
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