• Shinsuke Miyazaki, Hiroshi Taniguchi, Shigeki Kusa, Yuki Komatsu, Noboru Ichihara, Takamitsu Takagi, Jin Iwasawa, Akio Kuroi, Hiroaki Nakamura, Hitoshi Hachiya, Kenzo Hirao, and Yoshito Iesaka.
• Cardiology Division, Cardiovascular Center, Tsuchiura Kyodo Hospital, 11-7 Manabeshin-machi, Tsuchiura, Ibaraki 300-0053, Japan mshinsuke@k3.dion.ne.jp.
• Europace. 2015 Feb 1; 17 (2): 289-94.

AimsInappropriate shocks have been an important issue post-implantable cardioverter-defibrillator (ICD) implantation. Moreover, inappropriate ICD shocks are associated with increased mortality. The objective of this study was to evaluate the feasibility of catheter ablation therapy for atrial tachyarrhythmias (ATa) responsible for inappropriate ICD shocks.Methods And ResultsAmong 108 consecutive patients who underwent ICD implantations, 22, 5, and 3 experienced inappropriate ICD shocks due to ATa, sinus tachycardia, and T-wave oversensing, respectively. Among the 22 patients with ATa, 18 patients (55 ± 10 years, 15 men, structural heart disease in 9) underwent catheter ablation of ATa causing inappropriate shocks. The median duration between the ICD implantation and first inappropriate shock was 10.0 (3.0-24.5) months. The ATa were atrial fibrillation (AF), atrial flutter (AFL), and atrioventricular nodal reentrant tachycardia in 14, 2, and 2 patients, respectively. One patient underwent an atrioventricular nodal ablation for persistent AF associated with a venous anomaly. Among 13 patients who underwent pulmonary vein antrum isolation, 10 (76.9%) were free from AF for a median of 21.0 (13-37.3) months after an average of 1.3 ± 0.5 procedures. In four patients with AFL or a supraventricular tachycardia, none had any arrhythmia recurrence for a median of 6.0 (3.3-93.5) months after a cavotricuspid isthmus or slow pathway ablation, respectively. There were no procedural complications. During the median follow-up of 19.0 (9.5-37.3) months after the last procedure, no patients experienced any inappropriate shocks.ConclusionCatheter ablation is a feasible therapeutic option for treating ATa responsible for inappropriate shock(s) in patients with ICD.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

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