Catheter ablation using tailored substrate mapping rendered 79% of patients noninducible, with VT recurrence in 27% of noninducible versus 67% of inducible patients during follow-up (P=0.06).
Observational (n=28)
Does radiofrequency catheter ablation guided by limited mapping points achieve noninducibility in postinfarction patients with ventricular tachycardia?
Substrate-guided linear ablation using limited mapping points achieves high rates of noninducibility with short procedure times and no major complications in postinfarction VT.
Tasa de eventos absoluta: 27% vs 67%
valor p: p=0.06
INTRODUCTION: The aim of this study was to describe the arrhythmogenic substrate in postinfarction patients with ventricular tachycardia (VT) guiding the placement of individual strategic linear lesions transecting all potential isthmuses using target area maps with limited mapping points to allow short procedure times. METHODS AND RESULTS: In 28 patients with pleomorphic, unstable, and/or incessant VT, electroanatomic voltage mapping was performed in conjunction with limited sinus rhythm mapping, pace mapping, and activation mapping. Radiofrequency (RF) energy was applied directly within the low-voltage areas of the chronically infarcted areas or in the border zone. Ablation lines typically were perpendicular to the course of the presumed central common pathways. The maps consisted of 63 +/- 30 mapping points. An average lesion line length of 46 +/- 21 mm was placed with 17 +/- 7 RF pulses. Twenty-two (79%) of the 28 patients were rendered completely noninducible at the end of the procedure. Procedure time measured 134 +/- 41 minutes. No major complications were observed. Six (27%) of 22 patients who were rendered completely noninducible experienced VT recurrence during follow-up versus 4 (67%) of 6 patients who were still inducible after ablation (P = 0.06). CONCLUSION: Individually tailored substrate description guiding the placement of linear lesion lines transecting potential isthmuses rendered 80% of the patients completely noninducible. The construction of regional target area maps allowed short procedure times, with a resulting low incidence of complications in these critically ill patients.
Kottkamp et al. (Tue,) conducted a observational in Postinfarction ventricular tachycardia (n=28). Catheter ablation with strategic linear lesions was evaluated on Ventricular tachycardia recurrence during follow-up (comparing noninducible vs inducible patients post-ablation) (p=0.06). Catheter ablation using tailored substrate mapping rendered 79% of patients noninducible, with VT recurrence in 27% of noninducible versus 67% of inducible patients during follow-up (P=0.06).