Long-term outcome of endocardial-only versus combined endocardial-epicardial homogenization of the scar for treatment of ventricular tachycardia in patients with ischemic cardiomyopathy
Autor: | Gerald Gallinghouse, Domenico G. Della Rocca, Angel Mayedo, L. Di Biase, Rodney Horton, C. Trivedi, Mohamed Bassiouny, C Gianni, Bryan MacDonald, Swarup Ranjan Mohanty, Amin Al-Ahmad, John Burkhardt, Andrea Natale |
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Rok vydání: | 2021 |
Předmět: | |
Zdroj: | European Heart Journal. 42 |
ISSN: | 1522-9645 0195-668X |
Popis: | Introduction We investigated the ablation success of scar homogenization with combined (epicardial + endocardial) versus endocardial-only approach for ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) at 5 years of follow-up. Method Consecutive ICM patients undergoing VT ablation at our center were classified into group 1: endocardial scar homogenization and group 2: endocardial +epicardial scar homogenization. Patients with previous open heart surgery were excluded. All patients underwent bipolar substrate mapping with standard scar settings defined as normal tissue >1.5 mV and severe scar Results A total of 361 (Group 1: 291 and group 2: 70) patients were included in the study (mean age: 67 years, male: 88.4%). At 5 years, significantly higher number of patients from group 2 remained arrhythmia-free (figure 1). Of those patients, 87 (45%) and 51 (89%) from group 1 and 2 respectively were off-anti-arrhythmic drugs (AAD) (p Conclusion In this series of patients with ischemic cardiomyopathy and VT, endo-epicardial scar homogenization was associated with a lower need for AAD and a significantly lower recurrence rate at 5-years of follow-up compared to the endocardial ablation alone. Funding Acknowledgement Type of funding sources: None. Figure 1 |
Databáze: | OpenAIRE |
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