Usefulness of a Limited Linear Ablation of Post-Myocardial Infarction Ventricular Tachycardia Using a Standardized Approach Based on Sinus Rhythm Mapping
Autor: | Andreas Mügge, Markus Zarse, Dong-In Shin, Ricarda Rausse, Thomas Deneke, Bernd Calcum, Bernd Lemke, Thomas Lawo, Leif Bösche, Peter H Grewe, Marc Horlitz |
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Rok vydání: | 2010 |
Předmět: |
Adult
Male medicine.medical_specialty Substrate mapping Ablation Techniques medicine.medical_treatment Myocardial Infarction Infarction Ventricular tachycardia Post myocardial infarction Heart Rate Recurrence Internal medicine medicine Humans Sinus rhythm Aged Retrospective Studies Aged 80 and over business.industry Body Surface Potential Mapping Reproducibility of Results Middle Aged medicine.disease Ablation Catheter Ablation Tachycardia Ventricular Cardiology Female Cardiology and Cardiovascular Medicine business Linear ablation Follow-Up Studies |
Zdroj: | The American Journal of Cardiology. 105:1235-1239 |
ISSN: | 0002-9149 |
Popis: | The ablation of ventricular tachycardia (VT) can be achieved using anatomically guided approaches using differentiated mapping and ablation techniques. The aim of this study was to evaluate the efficacy of limited linear ablation in the VT exit region identified during sinus rhythm mapping alone. One hundred fifteen consecutive patients presenting for ablation of post-myocardial infarction VT were included. After induction of the target VT during invasive electrophysiology, left ventricular substrate mapping during sinus rhythm to identify scar and border zone on the basis of endocardial bipolar voltage was performed. The exit site of the target VT was regionalized by a simplified vector pace mapping approach and targeted using limited linear ablation within the scar border zone. Seventy-seven percent of all inducible VT was successfully ablated. In 71 patients (62%), no sustained VT was inducible at the end of ablation procedure (complete success). During a median follow-up period of 16 + or - 10 months, 89 patients (77%) had no documented sustained ventricular arrhythmia. Seven patients (2%) had recurrences of the initially ablated VT, and 16 (14%) had new-onset VT. Patients with complete success had a significantly lower number of ventricular arrhythmia reoccurrences than patients with incomplete ablation success (11% vs 37%, p = 0.002). In conclusion, postinfarct VT was effectively ablated in 97% of patients without mapping during ongoing VT using a simplified regional linear ablation approach targeting the scar border zone. Freedom from any ventricular arrhythmia was achieved in 77% of patients during midterm follow-up. |
Databáze: | OpenAIRE |
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