Key result
Catheter ablation for papillary muscle ventricular arrhythmias achieved an acute success rate of 88.1% and a long-term arrhythmia-free rate of 69.2%.
Why the study?
Catheter ablation of papillary muscle ventricular arrhythmias has been associated with unsatisfactory results, and features affecting acute and long-term procedural outcomes are not well established.
Does catheter ablation improve arrhythmia-free survival and is it safe in patients with papillary muscle ventricular arrhythmias?
Systematic Review (n=536)
Does catheter ablation improve arrhythmia-free survival and is it safe in patients with papillary muscle ventricular arrhythmias?
Catheter ablation is an effective and safe strategy for papillary muscle ventricular arrhythmias, with improved long-term outcomes when using intracardiac echocardiography, irrigated catheters, and contact force sensing.
Catheter ablation may be considered for refractory papillary muscle arrhythmias; extends observational data but leaves open need for randomized confirmation.
BACKGROUND: Catheter ablation of papillary muscle ventricular arrhythmias (PM-VAs) has been associated with unsatisfactory results. Features that may affect acute and long-term procedural outcomes are not well established. OBJECTIVE: To systematically review the available data in the literature assessing efficacy and safety of PM-VAs catheter ablation. METHODS: An online search of PubMed, Cochrane Registry, Web of Science, Scopus and EMBASE libraries (from inception to March 1, 2021) was performed, in addition to manual screening. Twenty-one observational noncontrolled case-series were considered eligible for the systematic review, including 536 patients. RESULTS: 0%). After a mean follow-up period of 15.5 ± 17.4 months, pooled long-term arrhythmia-free rate was 69.2%, while the pooled long-term success rate after multiple ablation procedure was 84.9%. Overall, procedure complications occurred in nine patients (1.7%) and no procedure-related deaths were reported. The use of intracardiac echocardiography (ICE) as well as contact force sensing (CFS) and irrigated catheters during ablation was associated with higher rates of arrhythmia-freedom at long-term follow-up. CONCLUSIONS: Catheter ablation is an effective and safe strategy for PM-VAs, with an acute success rate of 88.1%, a long-term success rate of 69.2%, with a relatively low procedural complication rate. The use of ICE, irrigated catheters and catheters with CFS capability was associated with higher rates of arrhythmia-freedom at long-term follow-up.
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Mariani et al. (2022) conducted a systematic review in Papillary muscle ventricular arrhythmias (PM-VAs) (n=536). Catheter ablation was evaluated on Long-term arrhythmia-free rate. Catheter ablation for papillary muscle ventricular arrhythmias achieved an acute success rate of 88.1% and a long-term arrhythmia-free rate of 69.2%.
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