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March 1, 2019Journal of Innovations in Cardiac Rhythm ManagementOpen Access

Substrate-based VT ablation matches or outperforms conventional methods in structural heart disease.

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Why the study?

The paper aims to review key developments, limitations, and outcomes of current substrate-based VT ablation mapping strategies, as well as the role of cardiac imaging.

Population

Patients with structural heart disease and VT

Design

Review

Key result

Substrate-based ablation for ventricular tachycardia in patients with structural heart disease yields a recurrence-free rate of 54% to 91%, showing comparable or superior outcomes to conventional ablation.

Authors

ΤKΤakeshi KitamuraCMClaire MartinKVKonstantinos Vlachos

Discussion

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Overview

May support substrate-based VT ablation in structural heart disease; leaves open need for randomized confirmation.

Structured PICO

P
Population
Patients with structural heart disease (SHD) undergoing catheter ablation for ventricular tachycardia (VT)
I
Intervention
Substrate mapping and ablation strategies (including electrogram-based mapping, multipolar mapping catheters, and cardiac imaging integration)

Substrate-based ablation strategies, aided by high-density multipolar mapping and cardiac imaging, are increasingly used and effective for treating ventricular tachycardia in patients with structural heart disease.

Limitations

  • Most currently available studies use data acquired by way of ablation catheters rather than high-density multipolar mapping catheters.
  • Limitations of conventional voltage mapping for substrate detection include variations due to wavefront of activation, catheter orientation, and contact.
  • Insufficient evidence from well-designed, prospective randomized studies to assess the true impact of image integration on clinical outcomes.

Cite This Study

Kitamura et al. (2019) conducted a review in Ventricular tachycardia in patients with structural heart disease. Substrate mapping and ablation vs. Conventional activation/entrainment mapping and ablation was evaluated. Substrate-based ablation for ventricular tachycardia in patients with structural heart disease yields a recurrence-free rate of 54% to 91%, showing comparable or superior outcomes to conventional ablation.

synapsesocial.com/papers/6a0f0d48c12540356222e393https://doi.org/10.19102/icrm.2019.100302
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