Key result
Radiofrequency catheter ablation guided by non-contact mapping for unstable ventricular tachycardia achieved long-term success in 62.5% of scar-related and 70% of idiopathic cardiomyopathy patients.
Why the study?
Does radiofrequency catheter ablation guided by non-contact mapping improve acute success, long-term recurrence, and ejection fraction in cardiomyopathic patients with unstable or non-sustained ventricular tachycardia?
Observational (n=18)
No
Does radiofrequency catheter ablation guided by non-contact mapping improve acute success, long-term recurrence, and ejection fraction in cardiomyopathic patients with unstable or non-sustained ventricular tachycardia?
Non-contact mapping-guided radiofrequency ablation of unstable ventricular tachycardia in cardiomyopathy patients is feasible and may improve left ventricular function in those with idiopathic dilated cardiomyopathy.
May support non-contact mapping for unstable VT in cardiomyopathy; hypothesis-generating and requires randomized trials before practice change.
We report our local experience in using the non contact mapping system in guiding catheter ablation of unstable/non sustained Ventricular tachycardia (VT) and its short and long term implications. This report includes 18 cardiomyopathic patients, 13 males, age 40.5 ± 15 yrs, who presented to our centre with VT that share in common being unstable or non sustained. The patients were subjected to radiofrequency catheter ablation guided by the non contact mapping system. Acute successful outcome was obtained in 6 out of 8 (75%) patients with scar related VTs (post myocardial infarction and arrhythmogenic right ventricular dysplasia) and 9 of 10 (90%) patients with idiopathic dilated cardiomyopathy. Long term follow up for 6–24 (16 ± 8) months showed recurrence in one case of the scar related group and in two cases of the idiopathic group, so the overall long term success rates were 62.5% vs 70% (P. NS). Regular Echocardiographic showed an improvement of 10–15% in the Ejection Fraction in successful cases of the idiopathic group (Average Post-ablation EF in the idiopathic group of 49 ± 5% vs pre-ablation EF of 41 ± 4% while 42 ± 6 pre Vs 42 ± 7% post ablation in the scar related group) (P < 0.01). Non contact mapping guided RF ablation of unstable VT in patients with cardiomyopathy showed good immediate results and long term outcome both in scar related and in idiopathic cardiomyopathy patients. Successful RF ablation of non sustained ventricular dysrhythmias among patients with idiopathic Cardiomyopathy may improve LV dysfunction.
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Atta et al. (2012) conducted an observational in Cardiomyopathy with unstable or non-sustained ventricular tachycardia (n=18). Radiofrequency catheter ablation guided by non contact mapping system vs. Idiopathic dilated cardiomyopathy (subgroup comparison vs scar-related) was evaluated on Long term success rate (scar-related vs idiopathic) (p=NS). Radiofrequency catheter ablation guided by non-contact mapping for unstable ventricular tachycardia achieved long-term success in 62.5% of scar-related and 70% of idiopathic cardiomyopathy patients.
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