November 7, 2023Circulation
Abstract 18141: Outcomes of Prospective Computational 12-Lead ECG Mapping to Guide Ablation of Unstable Ventricular Tachycardia
Key result
ECG mapping-guided unstable VT ablation is linked to ~77% less ICD shock or death vs standard ablation.
- HR 0.23
- 95% CI 0.07-0.70
- P=0.01
Why the study?
Unstable ventricular tachycardia is difficult to map and ablate, resulting in high recurrence rates.
Does computational 12-lead ECG mapping to guide ablation of unstable ventricular tachycardia reduce the risk of ICD shock or death compared to standard ablation?
Population
26 patients with unstable VT from 2 centers (out of 32 undergoing ECG-mapping guided ablation)
Comparison
ECG-mapping guided VT ablation vs standard VT ablation controls
Design
Prospective 2-center comparative cohort study
Follow-up
Mean 7.5 month f/u (minimum 3 month f/u)
Authors
Discussion
Loading...
Member takes
Implication
ECG mapping-guided ablation was associated with fewer ICD shocks or death in unstable VT; hypothesis-generating and requires randomized confirmation before practice change.
Study Design
Type
Cohort
Multicenter
Yes
Structured PICO
Does computational 12-lead ECG mapping to guide ablation of unstable ventricular tachycardia reduce the risk of ICD shock or death compared to standard ablation?
P
Population
26 patients with unstable ventricular tachycardia (from a total cohort of 32 undergoing ECG-mapping guided VT ablation), mean age 66±10 years, mean EF 34±17%, from 2 centers.
I
Intervention
Computational 12-lead ECG mapping to localize VT onto a 3D model to guide activation mapping and ablation.
C
Comparator
Standard ventricular tachycardia ablation controls.
O
Outcome
Time to ICD shock or death (minimum 3 month follow-up).composite
Main Result
Effect estimate: HR 0.23 (95% CI 0.07-0.70)
p-value: p=0.01
Prospective use of computational 12-lead ECG mapping to guide ablation of unstable ventricular tachycardia significantly reduces the composite risk of ICD shocks or death compared to standard ablation.
Cite This Study
Ho et al. (2023) conducted a cohort in Unstable ventricular tachycardia. Computational 12-lead ECG mapping guided ablation vs. Standard VT ablation was evaluated on Time to ICD shock or death (HR 0.23, 95% CI 0.07-0.70, p=0.01). ECG mapping-guided ablation of unstable ventricular tachycardia significantly reduced ICD shock or death compared to standard ablation (HR 0.23; 95% CI 0.07-0.70; p=0.01).