What does this research mean for the field?

Preprocedural imaging-guided ventricular tachycardia ablation eliminates VT inducibility in approximately half of patients and results in similar survival free from ICD shocks in both ischemic and nonischemic cardiomyopathy. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 14, 2025Journal of ArrhythmiaOpen Access

Editorial to “Pre‐procedural imaging guiding ventricular tachycardia ablation in structural heart disease”

Q: What is the clinical evidence from this study?

Study design: Editorial. Population: Ventricular tachycardia in structural heart disease (n=102). Intervention: Preprocedural imaging-guided VT ablation (ADAS 3D system) vs. Ischemic cardiomyopathy (ICM) vs Nonischemic cardiomyopathy (NICM). Primary outcome: Cumulative survival free from appropriate ICD shocks.

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Key result

Preprocedural imaging-guided VT ablation eliminated VT inducibility in ~50% of patients, with similar survival free from ICD shocks between ischemic and nonischemic cardiomyopathy groups.

Why the study?

Does preprocedural imaging-guided VT ablation yield similar freedom from appropriate ICD shocks in patients with nonischemic cardiomyopathy compared to those with ischemic cardiomyopathy?

Population

102 patients with ventricular tachycardia and structural heart disease

Comparison

Catheter ablation for VT guided by preprocedural… vs Comparison between patients with ischemic…

Design

Editorial

Authors

YMYoshiaki MizutaniElectrophysiology SYSatoshi YanagisawaElectrophysiology YIYasuya IndenNagoya University

Discussion

Member takes

Implication

Preprocedural imaging-guided VT ablation using advanced 3D mapping integration may provide similar freedom from ICD shocks in patients with nonischemic and ischemic cardiomyopathy, despite the more complex arrhythmogenic substrate typically found in NICM.

Structured PICO

Does preprocedural imaging-guided VT ablation yield similar freedom from appropriate ICD shocks in patients with nonischemic cardiomyopathy compared to those with ischemic cardiomyopathy?

Population

102 patients with ventricular tachycardia (VT) and structural heart disease (75 with ischemic cardiomyopathy [ICM], 27 with nonischemic cardiomyopathy [NICM])

Intervention

Catheter ablation for VT guided by preprocedural imaging (multidetector computed tomography [MDCT] and late gadolinium enhancement cardiac magnetic resonance [LGE-CMR]) integrated into the ADAS 3D system

Comparator

Comparison between patients with ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM)

Outcome

Cumulative survival free from appropriate ICD shockshard clinical

Limitations

Nonrandomized design
Significant differences in baseline characteristics between the two etiology groups
Did not account for episodes managed with anti-tachycardia pacing (ATP) following the procedure
Suboptimal sensitivity and specificity of preprocedural imaging for identifying local abnormal ventricular activities
Significant differences in baseline characteristics between the two etiology groups (mean age, prevalence of chronic kidney disease, and electrical storm)
Did not account for VT episodes managed with anti-tachycardia pacing (ATP)

Cite This Study

Mizutani et al. (2025) conducted an editorial in Ventricular tachycardia in structural heart disease (n=102). Preprocedural imaging-guided VT ablation (ADAS 3D system) vs. Ischemic cardiomyopathy (ICM) vs Nonischemic cardiomyopathy (NICM) was evaluated on Cumulative survival free from appropriate ICD shocks. Preprocedural imaging-guided VT ablation eliminated VT inducibility in ~50% of patients, with similar survival free from ICD shocks between ischemic and nonischemic cardiomyopathy groups.

synapsesocial.com/papers/6a16ac8b2fcf950e00052682 https://doi.org/10.1002/joa3.13211

Topics

Ventricular arrhythmias Cardiomyopathy AF ablation outcomes

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Editorial to “Pre‐procedural imaging guiding ventricular tachycardia ablation in structural heart disease”

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Editorial to “Pre‐procedural imaging guiding ventricular tachycardia ablation in structural heart disease”

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

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