scholarly journals Long-Term Outcome After Ventricular Tachycardia Ablation in Nonischemic Cardiomyopathy

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
Kenji Okubo ◽  
Lorenzo Gigli ◽  
Nicola Trevisi ◽  
Luca Foppoli ◽  
Andrea Radinovic ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Multivariable Analysis ◽  
Structural Heart Disease ◽  
Hazard Ratio ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ventricular Tachycardia Ablation ◽  
Vt Ablation

Background: In patients with an ischemic cardiomyopathy (ICM), the combination of late potential (LP) abolition and postprocedural ventricular tachycardia (VT) noninducibility is known to be the desirable end point for a successful long-term outcome after VT ablation. We investigated whether LP abolition and VT noninducibilty have a similar impact on the outcomes of patients with non-ICMs (NICM) undergoing VT ablation. Methods: A total of 403 patients with NICM (523 procedures) who underwent a VT ablation from 2010 to 2016 were included. The procedure end points were the LP abolition (if the LPs were absent, other ablation strategies were undertaken) and the VT noninducibilty. Results: The underlying structural heart disease consisted of dilated cardiomyopathy (DCM, 49%), arrhythmogenic right ventricular dysplasia (ARVD, 17%), postmyocarditis (14%), valvular heart disease (8%), congenital heart disease (2%), hypertrophic cardiomyopathy (2%), and others (5%). The epicardial access was performed in 57% of the patients. At baseline, the LPs were present in 60% of the patients and a VT was either inducible or sustained/incessant in 85% of the cases. At the end of the procedure, the LP abolition was achieved in 79% of the cases and VT noninducibility in 80%. After a multivariable analysis, the combination of LP abolition and VT noninducibilty was independently associated with free survival from VT (hazard ratio, 0.45 [95% CI, 0.29–0.69], P =0.0002) and cardiac death (hazard ratio, 0.38 [95% CI, 0.18–0.74], P =0.005). The benefit of the LP abolition on preventing the VT recurrence in patients with ARVD and postmyocarditis appeared superior to that observed for those with DCM. Conclusions: In patients with NICM undergoing VT ablation, the strategy of LP abolition and VT noninducibilty were associated with better outcomes in terms of long-term VT recurrences and cardiac survival. Graphic Abstract: A graphic abstract is available for this article.

scholarly journals Long-term Outcomes of Ventricular Tachycardia Ablation in Different Types of Structural Heart Disease

2015 ◽  
Vol 4 (3) ◽  
pp. 177 ◽  
Author(s):  
Jackson J Liang ◽  
Pasquale Santangeli ◽  
David J Callans ◽  
◽  
◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Structural Heart Disease ◽  
Implantable Cardioverter Defibrillators ◽  
Mortality Benefit ◽  
Long Term Outcomes ◽  
Ventricular Tachycardia Ablation ◽  
Different Types ◽  
Vt Ablation

Ventricular tachycardia (VT) often occurs in the setting of structural heart disease and can affect patients with ischaemic or nonischaemic cardiomyopathies. Implantable cardioverter-defibrillators (ICDs) provide mortality benefit and are therefore indicated for secondary prevention in patients with sustained VT, but they do not reduce arrhythmia burden. ICD shocks are associated with increased morbidity and mortality, and antiarrhythmic medications are often used to prevent recurrent episodes. Catheter ablation is an effective treatment option for patients with VT in the setting of structural heart disease and, when successful, can reduce the number of ICD shocks. However, whether VT ablation results in a mortality benefit remains unclear. We aim to review the long-term outcomes in patients with different types of structural heart disease treated with VT ablation.

scholarly journals Pre-procedural image-guided versus non-image-guided ventricular tachycardia ablation—a review

2020 ◽  
Vol 28 (11) ◽  
pp. 573-583 ◽  
Author(s):  
A. A. Hendriks ◽  
Z. Kis ◽  
M. Glisic ◽  
W. M. Bramer ◽  
T. Szili-Torok
Keyword(s):  
Overall Survival ◽  
Ventricular Tachycardia ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ventricular Tachycardia Ablation ◽  
Image Guided ◽  
Vt Ablation

Abstract Background Magnetic resonance imaging and computed tomography in patients with ventricular tachycardia (VT) after myocardial infarction (MI) helps to delineate scar from healthy tissue. Image-guided VT ablation has not yet been studied on a large scale. Objective The aim of the meta-analysis was to compare the long-term outcome of image-guided VT ablation with a conventional approach for VT after MI. Methods Eight electronic bibliographic databases were searched to identify all relevant studies from 2012 until 2018. The search for scientific literature was performed for studies that described the outcome of VT ablation in patients with an ischaemic substrate. The outcome of image-guided ablation was compared with the outcome of conventional ablations. Results Of the 2990 citations reviewed for eligibility, 38 articles—enrolling a total of 7748 patients—were included into the meta-analysis. Five articles included patients with image-guided ablation. VT-free survival was 82% [74–90] in the image-guided VT ablation versus 59% [54–64] in the conventional ablation group (p < 0.001) during a mean follow-up of 35 months. Overall survival was 94% [90–98] in the image-guided versus 82% [76–88] in the conventional VT ablation group (p < 0.001). Conclusions Image-guided VT ablation in ischaemic VT was associated with a significant benefit in VT-free and overall survival as compared with conventional VT ablation. Visualising myocardial scar facilitates substrate-guided ablation procedures, pre-procedurally and by integrating imaging during the procedure, and may consequently improve long-term outcome.

scholarly journals Long-term outcome of verapamil-sensitive sustained left ventricular tachycardia in patients without structural heart disease

1995 ◽  
Vol 25 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Tohru Ohe ◽  
Naohiko Aihara ◽  
Shiro Kamakura ◽  
Takashi Kurita ◽  
Wataru Shimizu ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Term Outcome ◽  
Long Term Outcome

Predictors of long-term mortality after catheter ablation of ventricular tachycardia in a contemporary cohort of patients with structural heart disease

EP Europace ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. 1672-1679
Author(s):  
Angeliki Darma ◽  
Livio Bertagnolli ◽  
Borislav Dinov ◽  
Federica Torri ◽  
Alireza Sepehri Shamloo ◽  
...  
Keyword(s):  
Heart Disease ◽  
Structural Heart Disease ◽  
Left Ventricular ◽  
Male Gender ◽  
Electrical Storm ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ischaemic Cardiomyopathy

Abstract Aims Ablation of ventricular tachycardias (VTs) in patients with structural heart disease has been established in the past decades as an effective and safe treatment. However, the prognosis and long-term outcome remains poor. Methods and results We investigated 309 patients with ischaemic cardiomyopathy (ICM) and non-ischaemic cardiomyopathy (NICM) (186 ICM, 123 NICM; 271 males; mean age 64.1 ± 12 years; ejection fraction 34 ± 13%) after ≥1 VT ablations over a mean follow-up period of 34 ± 28 months. Electrical storm was the indication for 224 patients (73%), whereas 86 patients (28%) underwent epicardial as well as endocardial ablation. During follow-up, 132 patients (43%) experienced VT recurrence and 97 (31%) died. Ischaemic cardiomyopathy and NICM patients showed comparable results, regarding procedural endpoints, complications, VT recurrence and survival. The Cox-regression analysis for all-cause mortality revealed that the presence of higher left ventricular end-diastolic volume (LVEDV; P &lt; 0.001), male gender (P = 0.018), atrial fibrillation (AF; P &lt; 0.001), chronic obstructive pulmonary disease (COPD; P = 0.001), antiarrhythmic drugs during the follow-up (P &lt; 0.001), polymorphic VTs (P = 0.028), and periprocedural complications (P = 0.001) were independent predictors of mortality. Conclusion Ischaemic cardiomyopathy and NICM patients undergoing VT ablation had comparable results regarding procedural endpoints, complications, VT recurrence and 3-year mortality. Higher LVEDV, male gender, COPD, AF, polymorphic VTs, use of antiarrhythmics, and periprocedural complications are strong and independent predictors for increased mortality. The PAINESD score accurately predicted the long-term outcome in our cohort.

Catheter ablation for ventricular tachycardia in ischaemic heart disease; Acute success and long-term outcome

2014 ◽  
Vol 48 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Thibault Johan Mørk ◽  
Jens Kristensen ◽  
Jens Christian Gerdes ◽  
Henrik Kjærulf Jensen ◽  
Peter Lukac ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Ischaemic Heart Disease ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Acute Success
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