June 20, 2014Journal of Cardiovascular Electrophysiology
Biophysical Parameters During Radiofrequency Catheter Ablation of Scar‐Mediated Ventricular Tachycardia: Epicardial and Endocardial Applications via Manual and Magnetic Navigation
Key result
Epicardial lesions achieved impedance drops more often than endocardial lesions (90% vs 76%, P=0.002), and manual delivery was more effective than magnetic navigation (83% vs 71%, P=0.02).
Why the study?
Do biophysical parameters differ between epicardial vs endocardial and manual vs magnetic navigation during radiofrequency ablation of scar-mediated VT?
Population
21 consecutive patients undergoing radiofrequency ablation with open-irrigation for scar-mediated…
Comparison
Radiofrequency catheter ablation vs Internal comparisons: epicardial vs. endocardial…
Design
Cohort
Authors
Discussion
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Implication
May support preferential epicardial manual delivery for lesion creation in scar VT; hypothesis-generating and does not yet justify practice change.
Study Design
Type
Observational (n=21)
Structured PICO
Do biophysical parameters differ between epicardial vs endocardial and manual vs magnetic navigation during radiofrequency ablation of scar-mediated VT?
P
Population
21 consecutive patients undergoing open-irrigation radiofrequency ablation for scar-mediated ventricular tachycardia, from which 372 lesions were analyzed.
E
Exposure
Radiofrequency catheter ablation (epicardial and endocardial applications via manual and magnetic navigation)
C
Comparator
Internal comparisons: epicardial vs. endocardial lesions, and manual vs. magnetic navigation
O
Outcome
Changes in biophysical parameters (>10Ω impedance reduction, bipolar EGM reduction, loss of capture, unipolar injury current, elimination of late potentials)surrogate
Main Result
Absolute Event Rate: 90% vs 76%
p-value: p=0.002
Radiofrequency ablation for scar-mediated VT is often inefficient at achieving multiple biophysical parameters, though epicardial and manual applications appear more effective than endocardial and magnetic navigation, respectively.
Cite This Study
Bourke et al. (2014) conducted an observational in Scar-mediated ventricular tachycardia (n=21). Epicardial ablation and manual navigation vs. Endocardial ablation and magnetic navigation was evaluated on >10Ω impedance drop (epicardial vs. endocardial lesions) (p=0.002). Epicardial lesions achieved impedance drops more often than endocardial lesions (90% vs 76%, P=0.002), and manual delivery was more effective than magnetic navigation (83% vs 71%, P=0.02).