130Long-term outcomes of ventricular tachycardia substrate ablation incorporating hidden slow conduction analysis
| Autor: | David Soto-Iglesias, Juan Fernández-Armenta, Alonso Pedrote, Antonio Berruezo, Diego Penela, Eduardo Arana-Rueda, Manuel Frutos-López, J Acosta Martinez, B. Jauregui-Garrido |
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| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | EP Europace. 22 |
| ISSN: | 1532-2092 1099-5129 |
| DOI: | 10.1093/europace/euaa162.098 |
| Popis: | Introduction Ventricular tachycardia substrate ablation (VTSA) incorporating hidden slow conduction (HSC) analysis allows further arrhythmic substrate identification. This study evaluates whether the analysis and elimination of HSC electrograms (HSC-EGMs) during VTSA procedures result in better short and long-term outcomes. Methods Consecutive patients (n = 70, 63% ischaemic, 64 ± 14.6 years) undergoing VTSA were prospectively included. Bipolar EGMs with >3 deflections and duration Results 5076 EGMs were analyzed. 1029 (20.2%) qualified as potential HSC-EGM, and 453 of them were tagged as HSC-EGMs. Scars in patients with HSC-EGMs (n = 43, 61.4%) were smaller (39.66 ± 28.2 vs 69.4 ± 38.2 cm2; p = 0.005) and more heterogeneous (core/scar area ratio 0.24 ± 0.2 vs 0.43 ± 0.17; p = 0.03). 29.6% of HSC-EGMs were located in normal-voltage tissue; 83.5% were targeted for ablation. Patients undergoing VTSA incorporating HSC analysis needed less procedure time (213 ± 75 vs 242 ± 60 min; p = 0.018), less RF time (15.9 ± 10 vs 25 ± 12,7 minutes; p Conclusion VTSA incorporating HSC analysis allowed further arrhythmic substrate identification (especially in normal-voltage areas) and resulted in increased VTSA efficiency and better short and long-term outcomes. Abstract Figure. VT Recurrence-Free Survival |
| Databáze: | OpenAIRE |
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