Key result
Trigger ablation in idiopathic VF linked to reduction in significant events from median 4 to 0.
Why the study?
Catheter ablation targeting ventricular premature beat triggers has shown short-term prevention of idiopathic VF recurrences, but long-term follow-up data are needed.
Cohort (n=38)
Yes
Ablation targeting short-coupled VPBs was associated with fewer events in idiopathic VF; leaves open long-term benefit and requires randomized trials.
OBJECTIVES: This multicenter study sought to evaluate the long-term follow-up of patients ablated for idiopathic ventricular fibrillation (VF). BACKGROUND: Catheter ablation of idiopathic VF that targets ventricular premature beat (VPB) triggers has been shown to prevent VF recurrences on short-term follow-up. METHODS: From January 2000, 38 consecutive patients from 6 different centers underwent ablation of primary idiopathic VF initiated by short coupled VPB. All patients had experienced at least 1 documented VF, with 87% having experienced > or =2 VF episodes in the preceding year. Catheter ablation was guided by activation mapping of VPBs or pace mapping during sinus rhythm. RESULTS: There were 38 patients (21 men) age 42 +/- 13 years, refractory to a median of 2 antiarrhythmic drugs. Triggering VPBs originated from the right (n = 16), the left (n = 14), or both (n = 3) Purkinje systems and from the myocardium (n = 5). During a median post-procedural follow-up of 63 months, 7 (18%) of 38 patients experienced VF recurrence at a median of 4 months. Five of these 7 patients underwent repeat ablation without VF recurrence. Survival free of VF was predicted only by transient bundle-branch block in the originating ventricle during the electrophysiological study (p < 0.0001). The number of significant events (confirmed VF or aborted sudden death) was reduced from 4 (interquartile range 3 to 9) before to 0 (interquartile range 0 to 4) after ablation (p = 0.01). CONCLUSIONS: Ablation for idiopathic VF that targets short coupled VPB triggers is associated with a long-term freedom from VF recurrence.
No takes yet. Share an insight, caveat, or question.
Knecht et al. (2009) conducted a cohort in Primary idiopathic ventricular fibrillation (n=38). Catheter ablation targeting short coupled VPB triggers vs. Pre-ablation baseline was evaluated on Significant events (confirmed VF or aborted sudden death) (p=0.01). Catheter ablation targeting short coupled VPB triggers in patients with idiopathic VF reduced the median number of significant events from 4 before ablation to 0 after ablation (p=0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: