Key result
The combined use of intracardiac echocardiography and contact force sensing during catheter ablation of left ventricular papillary muscle arrhythmias improved the acute success rate to 100% compared to 66.7% in the control group.
Why the study?
Catheter ablation of ventricular arrhythmias arising from the left ventricular papillary muscles is challenging, and whether combining intracardiac echocardiography with contact force sensing improves outcomes is unknown.
Does the combination of intracardiac echocardiography and contact force sensing improve acute success and reduce recurrence in patients undergoing ablation for left ventricular papillary muscle arrhythmias?
Cohort (n=33)
No
Does the combination of intracardiac echocardiography and contact force sensing improve acute success and reduce recurrence in patients undergoing ablation for left ventricular papillary muscle arrhythmias?
The combination of intracardiac echocardiography and contact force sensing during ablation of left ventricular papillary muscle arrhythmias significantly improves acute success and reduces long-term recurrence while requiring less X-ray time.
Answers are grounded in this paper and cite their sources.
May support ICE/CFS for papillary muscle VA ablation; hypothesis-generating and requires randomized confirmation.
Objectives Catheter ablation of ventricular arrhythmias (VAs) arising from the left ventricular (LV) papillary muscles (PM) is challenging. This study sought to address whether combination of intracardiac echocardiography (ICE) and contact force sensing (CFS) can improve acute and long-term ablation outcomes of left ventricular papillary muscle arrhythmias. Methods and Results From May 2015 to August 2022, a total thirty-three patients underwent catheter ablation for LV PM arrhythmias: VAs was located in anterolateral PM in 11, posteromedial PM in 22. Combination of intracardiac echocardiography (ICE) and contact force sensing (CFS) was used in 21 of the 33 procedures. The mean 6.93±4.91 lesions were used per patient and were comparable between the CFS/ICE and No ICE/CFS (4.90±2.23 vs. 10.17±5.89; P=0.011).The mean CF achieved in ICE/CFS group were 7.52±3.31g. Less X-ray time were used in combination group (CFS/ICE: 165.67±47.80 S vs. No ICE/CFS: 365.00±183.73 S; P<0.001). Acute success rate was 100% for ICE/CFS group (n=22) and 66.67% for No ICE/CFS group (n=8). VAs recurrence at 11.21±7.21 months follow-up was 14.2% for ICE/CFS group and 50.00% for No ICE/CFS group (P=0.04). No severe complications occurred in all patients. Conclusion Combination of intracardiac echocardiography (ICE) and contact force sensing (CFS) can provide precise geometries of cardiac endo cavitary structures and accurate contact information of catheter during ablation, which improved acute and long-term ablation outcomes. Routine adoption of this strategy should be considered to improve outcomes of LV PM VAs ablation.
No takes yet. Share an insight, caveat, or question.
Chen et al. (2022) conducted a cohort in Left ventricular papillary muscle arrhythmias (n=33). Combination of intracardiac echocardiography (ICE) and contact force sensing (CFS) vs. Catheter ablation without combined ICE and CFS was evaluated on Acute success rate of catheter ablation (p=0.012). The combined use of intracardiac echocardiography and contact force sensing during catheter ablation of left ventricular papillary muscle arrhythmias improved the acute success rate to 100% compared to 66.7% in the control group.
Synapse has enriched 8 closely related papers on similar clinical questions. Consider them for comparative context: