Key result
Post-MI radiofrequency ablation is linked to a 15-msec QRS prolongation without modifying other risk factors.
Why the study?
Relationships between noninvasive risk factors for ventricular arrhythmias and scar characteristics, as well as their modifications by ablation in post-MI patients, were unknown.
Does radiofrequency ablation modify noninvasive risk stratification parameters in patients with previous myocardial infarction?
Observational (n=22)
Does radiofrequency ablation modify noninvasive risk stratification parameters in patients with previous myocardial infarction?
Radiofrequency ablation in post-MI patients increases QRS duration but does not significantly modify other noninvasive risk stratification parameters like HRV or TWA.
RFA-associated QRS prolongation should not yet alter noninvasive risk stratification in post-MI patients; leaves open effects on arrhythmic outcomes.
INTRODUCTION: Several noninvasive risk factors for ventricular arrhythmias have been described in postmyocardial infarction (MI) patients, whose relationships with scar characteristics and modifications by ablation are unknown. METHODS: Twenty-two patients with previous MI referred for ventricular tachycardia ablation were prospectively included. ECG, heart rate variability (HRV), signal-averaged ECG (SA-ECG), and T wave alternans (TWA) were performed before and after radiofrequency ablation. Scar areas were correlated to preablation parameters. Pre and postablation parameters were furthermore compared. RESULTS: Left ventricular ejection fraction and some spectral and time-domain HRV parameters were significantly correlated to the scar areas. QRS duration was larger after vs before ablation (120 ± 29 vs 105 ± 22 msec, P = .01). No significant modification in time or spectral domain of HRV was observed. There was no significant change in TWA and SA-ECG before and after ablation. Borderline decreases in quantitative TWA parameters were noted in patients with positive TWA and successful ablation procedure. CONCLUSION: Some noninvasive risk factors were linked to the scar areas, but few were significantly modified after ablation. Larger populations are needed to demonstrate significant differences or correlations.
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Voglimacci‐Stephanopoli et al. (2019) conducted an observational in Ischemic heart disease with previous myocardial infarction referred for ventricular tachycardia ablation (n=22). Radiofrequency ablation vs. Pre-ablation was evaluated on QRS duration (p=.01). Radiofrequency ablation in post-MI patients significantly increased QRS duration (120 vs 105 msec, P=.01) but did not significantly modify other noninvasive risk factors.
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