Redo ventricular tachycardia ablation mapping revealed that while disease progression occurred in 75% of patients, incomplete index ablation was the most common finding (70%).
Observational (n=20)
Yes
Are VT recurrences in ARVC and NICM related to incomplete ablation or disease progression?
In patients with ARVC and NICM experiencing VT recurrence, incomplete index ablation is the most common finding despite frequent disease progression, suggesting a need for more extensive initial ablation.
AIM: To determine whether ventricular tachycardia (VT) recurrences in arrhythmogenic RV cardiomyopathy (ARVC) and nonischemic cardiomyopathy (NICM) are related to incomplete ablation or disease progression. METHODS: ARVC and NICM patients with two substrate maps of the same diseased ventricle with an interprocedural delay of ≥12 months were included. Disease progression was defined as ≥1 factor: scar area progression (PROG, +5%), ventricular remodeling (dilatation +25 mL or decreased ejection fraction -5%EF). Incomplete ablation was defined as index VT recurrence or ablation in previously unablated regions inside index scar without PROG. RESULTS: Twenty patients from nine centers were included (80% male 55 ± 16 years, 7 ARVC and 13 NICM, LVEF 43 ± 14%). Mean delay was 28 ± 18 months. Disease progression occurred in 75% with ventricular remodeling in 70%: ventricular dilation in 45% (ARVC 71%; NICM 38%), decreased EF in 60% RVEF in ARVC (71%); LVEF in NICM (54%), and scar progression in 50% (in ARVC 57% and NICM 46%). Index VT recurrence was observed in 40%. Redo ablation sites were located in previously unablated regions inside the index scar in 70% of patients. VT recurrence following the second procedure was seen in 25%. Fifteen percent died during a follow-up of 17 ± 17 months. CONCLUSION: Disease progression is the rule in ARVC and NICM while scar progression occurs in half. However, even if disease progression is frequently observed, incomplete index ablation is the most common finding, strongly suggesting the need for more extensive ablation.
Berte et al. (Fri,) conducted a observational in Arrhythmogenic RV cardiomyopathy (ARVC) and nonischemic cardiomyopathy (NICM) with ventricular tachycardia (n=20). Redo ventricular tachycardia ablation and substrate mapping was evaluated on Disease progression (scar area progression or ventricular remodeling) and incomplete ablation. Redo ventricular tachycardia ablation mapping revealed that while disease progression occurred in 75% of patients, incomplete index ablation was the most common finding (70%).