Why the study?
Although VT non-inducibility post-ablation is linked to fewer recurrences, whether to use it as a routine procedural end point remains unclear.
Do factors such as LVEF ≥35% and partial acute success predict reduced VT recurrence in patients who do not achieve VT non-inducibility at the end of RF ablation?
Do factors such as LVEF ≥35% and partial acute success predict reduced VT recurrence in patients who do not achieve VT non-inducibility at the end of RF ablation?
In patients who do not achieve VT non-inducibility after RF ablation, having an LVEF ≥35% or achieving partial acute success strongly predicts a lower risk of VT recurrence.
Failure to achieve non-inducibility does not preclude favorable VT ablation outcomes; leaves open its value as a routine endpoint.
Background: Ventricular tachycardia (VT) non-inducibility at the end of ablation is associated with a less likely VT recurrence. However, it is not clear whether we should use VT non-inducibility as a routine end point of VT ablation. The aim of this study was to evaluate VT recurrence in patients in whom VT non-inducibility was not achieved at the end of the RF ablation and the factors attributing to the VT recurrence. Methods: We analyzed 62 patients in whom VT non-inducibility was not achieved at the end of the RF ablation were studied. Results : Over 2 years, 22 (35%) of the cases had VT recurrences. A multivariate analysis showed that an LVEF≥35% (HR:0.19; 95% CI:0.06- 0.49; P<0.01) and partial success as an acute ablation efficacy (HR:0.23; 95% CI:0.04- 0.81; P=0.02) were independent predictors of fewer VT recurrences. RF ablation was associated with a 91.1% reduction in VT episodes. Conclusion: Even if VT non-inducibility was not achieved, patients with an LVEF≥35% or in whom partial success could be achieved might be prevented from having VT recurrences. The validity of the VT non-inducibility of any VT should be evaluated considering each patient’s background and the results of the procedure.
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Nakasone et al. (2022) studied this question.
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