Prognostic significance of extensive versus limited induction protocol during catheter ablation of scar‐related ventricular tachycardia

2020 ◽  
Vol 31 (11) ◽  
pp. 2909-2919
Author(s):  
Timothy Campbell ◽  
Richard G. Bennett ◽  
Kartheek Garikapati ◽  
Samual Turnbull ◽  
Ashwin Bhaskaran ◽  
...  
EP Europace ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. 1680-1687
Author(s):  
Konstantinos C Siontis ◽  
Hyungjin M Kim ◽  
Pasquale Vergara ◽  
Giovanni Peretto ◽  
Duc H Do ◽  
...  

Abstract Aims  Catheter ablation is an effective treatment for post-infarction ventricular tachycardia (VT). However, some patients may experience a worsened arrhythmia phenotype after ablation. We aimed to determine the prevalence and prognostic impact of arrhythmia exacerbation (AE) after post-infarction VT ablation. Methods and results  A total of 1187 consecutive patients (93% men, median age 68 years, median ejection fraction 30%) who underwent post-infarction VT ablation at six centres were included. Arrhythmia exacerbation was defined as post-ablation VT storm or incessant VT in patients without prior similar events. During follow-up (median 717 days), 426 (36%) patients experienced VT recurrence. Events qualifying as AE occurred in 67 patients (6%). Median times to VT recurrence with and without AE were 238 [interquartile range (IQR) 35–640] days and 135 (IQR 22–521) days, respectively (P = 0.25). Almost half of the patients (46%) who experienced AE experienced it within 6 months of the index procedure. Patients with AE had had longer ablation times during the ablation procedures compared to the rest of the patients (median 42 vs. 34 min, P = 0.02). Among patients with VT recurrence, the risk of death or heart transplantation was significantly higher in patients with than without AE (hazard ratio 1.99, 95% CI 1.28–3.10; P = 0.002) after adjusting for age, gender, ejection fraction, cardiac resynchronization therapy, post-ablation non-inducibility, and post-ablation amiodarone use. Conclusion  Arrhythmia exacerbation after ablation of infarct-related VT is infrequent but is independently associated with an adverse long-term outcome among patients who experience a VT recurrence. The mechanisms and mitigation strategies of AE after catheter ablation require further investigation.


2018 ◽  
Vol 108 (5) ◽  
pp. 539-548 ◽  
Author(s):  
Francesco Santoro ◽  
Andreas Metzner ◽  
Leonie Scholz ◽  
Natale Daniele Brunetti ◽  
Christian-H Heeger ◽  
...  

2007 ◽  
Vol 62 (2) ◽  
pp. 163-169 ◽  
Author(s):  
S. WU ◽  
W.F. KERWIN ◽  
C.T. PETER ◽  
E.S. GANG ◽  
H. MA

2021 ◽  
Vol 77 (18) ◽  
pp. 249
Author(s):  
Nathan Kong ◽  
Dalise Shatz ◽  
Stephanie Besser ◽  
Zaid Aziz ◽  
Cevher Ozcan ◽  
...  

2020 ◽  
pp. 1-3
Author(s):  
Keiko Toyohara ◽  
Yasuko Tomizawa ◽  
Morio Shoda

Abstract We report a case with Ebstein’s anomaly and pulmonary atresia with sustained monomorphic ventricular tachycardia in a patient without a ventriculotomy history. In the low voltage area between the atrialised right ventricle and hypoplastic right ventricle, there was a ventricular tachycardia substrate and slow conduction. The tachycardia circuit was eliminated by a point catheter ablation at the area with diastolic fractionated potentials.


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