Safety and Outcomes of Ventricular Tachycardia Substrate Ablation During Sinus Rhythm
| Autor: | Markus Linhart, Eduard Guasch, David Soto-Iglesias, Etel Silva, Roger Villuendas, Juan Acosta, Marcos Fernández, Lucas Cano, Diego Penela, J. Fernandez-Armenta, Roger Borràs, Antonio Berruezo, Beatriz Jáuregui, Felipe Bisbal, Lluís Mont |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Ischemic cardiomyopathy Ejection fraction Heart disease business.industry medicine.medical_treatment Hazard ratio Catheter ablation 030204 cardiovascular system & hematology Ventricular tachycardia medicine.disease Ablation 03 medical and health sciences 0302 clinical medicine Internal medicine Cardiology Medicine Sinus rhythm 030212 general & internal medicine business |
| Zdroj: | JACC: Clinical Electrophysiology. 6:1435-1448 |
| ISSN: | 2405-500X |
| Popis: | Objectives This study sought to analyze safety and outcomes of ventricular tachycardia (VT) substrate ablation during sinus rhythm (SR), without baseline VT induction. Background Safety and outcomes after scar-related VT ablation during SR are not well known. Hemodynamic instability and need for electrical cardioversion can compromise safety of VT ablation procedures. Methods Four hundred twelve consecutive patients with structural heart disease undergoing VT ablation were included in a prospective multicenter registry. Substrate ablation during SR, without baseline VT induction, was the first step of the ablation procedure and the standard protocol. Scar dechanneling was the substrate ablation technique used. VT inducibility was tested after substrate ablation. Results VT induction protocol was negative after substrate ablation in 289 patients (70.1%), completing the procedure in SR. Procedure-related complication rate was 6.5%, including 1 death (0.2%). Thirty-day mortality after first VT ablation procedure was 1.7%. Overall survival was 95.8% and 88.6% at 1 and 3 years of follow-up, respectively. In a multivariable proportional hazards regression model, age ≥70 years (hazard ratio [HR]: 4.95 [2.59 to 9.47]; p Conclusions Substrate ablation during SR avoiding multiple VT induction has low procedure-related complications and low early mortality. Age, chronic obstructive pulmonary disease, and reduced left ventricular ejection fraction, but also incomplete substrate elimination, are predictors of mortality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|