A screening for cerebral deoxygenation during VT ablations in patients with structural heart disease.

Autor: Müller J; Department of Cardiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, University of Freiburg, Freiburg im Breisgau, Germany. julian.mueller@uniklinik-freiburg.de., Koch L; Department of Cardiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, University of Freiburg, Freiburg im Breisgau, Germany., Halbfass P; Department of Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany., Nentwich K; Clinic for Interventional Electrophysiology, Heart Centre Bad Neustadt, Bad Neustadt a. d. Saale, Germany.; Department of Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany., Berkovitz A; Clinic for Interventional Electrophysiology, Heart Centre Bad Neustadt, Bad Neustadt a. d. Saale, Germany., Barth S; Clinic for Interventional Electrophysiology, Heart Centre Bad Neustadt, Bad Neustadt a. d. Saale, Germany.; Department of Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany., Wächter C; Department of Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany., Lehrmann H; Department of Cardiology, Faculty of Medicine, University Heart Center Freiburg-Bad Krozingen, University of Freiburg, Freiburg im Breisgau, Germany., Deneke T; Clinic for Interventional Electrophysiology, Heart Centre Bad Neustadt, Bad Neustadt a. d. Saale, Germany.; Clinic for Electrophysiology, Klinikum Nuernberg, Campus South, University Hospital of the Paracelsus Medical University, Nuremberg, Germany.
Jazyk: angličtina
Zdroj: Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2024 Jul 16. Date of Electronic Publication: 2024 Jul 16.
DOI: 10.1007/s00392-024-02493-4
Abstrakt: Background: Patients undergoing ventricular tachycardia (VT) ablation often present with structural heart disease (SHD) and reduced ejection fraction. Inducing VT by programmed electrical stimulation (PES) puts these patients at risk for hemodynamic instability and cerebral hypoperfusion.
Objective: The present study screens for cerebral oxygen desaturation phases (ODPs) in patients undergoing VT ablation.
Methods: Forty-seven patients (age 61 ± 14 years, 72% males) underwent ablation of sustained VT with simultaneous neuromonitoring using near-infrared spectroscopy (NIRS).
Results: Analysis of NIRS signal identified ODPs in 29 patients (62%). ODPs were associated with a higher prevalence of ischemic heart disease (IHD) (45% vs. 11%, p = 0.024), previous VT episodes (n = 16 vs. 4, p = 0.018), and VTs inducible by PES (n = 2.4 vs. 1.2, p = 0.004). Patients with ODPs were more likely to be admitted to intensive care unit (ICU) (78% vs. 33%, p = 0.005) and had more in-hospital VT recurrences (24% vs. 0%, p = 0.034). No differences were observed in VT recurrence rates after hospital discharge (41.4% vs. 44.4%, p = 0.60) and left ventricular ejection fraction (34% vs. 38%, p = 0.567). IHD (OR: 32.837, p = 0.006), ICU admission (OR: 14.112, p = 0.013), and the number of VTs inducible at PES (OR: 2.705, p = 0.015) were independently associated with ODPs.
Conclusions: This study registers episodes of cerebral hypoperfusion in 62% of patients undergoing VT ablation and identifies IHD and the number of VTs inducible at PES as possible risk factors for these episodes.
(© 2024. The Author(s).)
Databáze: MEDLINE
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