Outcome of Repeat Ablation for Premature Ventricular Contractions in Patients with Prior Ablation Failure: Impact of Advanced Techniques

The utility of repeat ablation for premature ventricular contractions (PVCs) after prior ablation failure is not clear. To assess the outcomes of repeat ablation and the use of different techniques in patients who failed prior PVC ablation. We reviewed 239 consecutive patients who underwent PVC ablation. When standard endocardial ablation with normal or half normal saline failed, we considered an advanced ablation technique. Acute success was defined as abolition of the target PVC. Clinical and procedural findings, PVC origins and acute and follow-up outcomes were compared in those with and without a prior failed ablation procedure. Of 239 patients, 75 (31%) patients had failed a prior ablation procedure and they more often had LVOT PVCs. Despite failing prior ablation repeat standard ablation was acutely successful in 59% of patients and 75% of these patients had long-term success. Acute standard ablation success rate was lower and long-term recurrence rate was higher compared to patients without prior ablation (59% vs 95%; P