Preventive substrate ablation in chronic post-myocardial infarction patients with high-risk scar characteristics for ventricular arrhythmias: rationale and design of PREVENT-VT study

Autor: Giulio Falasconi, Diego Penela, David Soto-Iglesias, Pietro Francia, Cheryl Teres, Daniel Viveros, Aldo Bellido, Jose Alderete, Julia Meca-Santamaria, Paula Franco, Augusto Ordoñez, Marta Díaz-Escofet, Maria Matiello, Giuliana Maldonado, Claudia Scherer, Marina Huguet, Óscar Cámara, José-Tomás Ortiz-Pérez, Julio Martí-Almor, Antonio Berruezo
Rok vydání: 2022
Předmět:
Zdroj: Journal of Interventional Cardiac Electrophysiology. 66:39-47
ISSN: 1572-8595
DOI: 10.1007/s10840-022-01392-w
Popis: Recent studies showed that an early strategy for ventricular tachycardia (VT) ablation resulted in reduction of VT episodes or mortality. Cardiac magnetic resonance (CMR)-derived border zone channel (BZC) mass has proved to be a strong non-invasive predictor of VT in post-myocardial infarction (MI). CMR-guided VT substrate ablation proved to be safe and effective for reducing sudden cardiac death (SCD) and VA occurrence.PREVENT-VT is a prospective, randomized, multicenter, and controlled trial designed to evaluate the safety and efficacy of prophylactic CMR-guided VT substrate ablation in chronic post-MI patients with CMR-derived arrhythmogenic scar characteristics. Chronic post-MI patients with late gadolinium enhancement (LGE) CMR will be evaluated. CMR images will be post-processed and the BZC mass measured: patients with a BZC mass 5.15 g will be eligible. Consecutive patients will be enrolled at 3 centers and randomized on a 1:1 basis to undergo a VT substrate ablation (ABLATE arm) or optimal medical treatment (OMT arm). Primary prevention ICD will be implanted following guideline recommendations, while non-ICD candidates will be implanted with an implantable cardiac monitor (ICM). The primary endpoint is a composite outcome of sudden cardiac death (SCD) or sustained monomorphic VT, either treated by an ICD or documented with ICM. Secondary endpoints are procedural safety and efficiency outcomes of CMR-guided ablation.In some patients, the first VA episode causes SCD or severe neurological damage. The aim of the PREVENT-VT is to evaluate whether primary preventive substrate ablation may be a safe and effective prophylactic therapy for reducing SCD and VA occurrence in patients with previous MI and high-risk scar characteristics based on CMR.ClinicalTrials.gov, NCT04675073, registered on January 1, 2021.
Databáze: OpenAIRE
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