Integrating pre-procedural cardiac CT with electro-anatomical mapping during VT ablation in patients with ischaemic heart disease reduced 1-year VT recurrence (26% vs 44%, p=0.024).
Cohort (n=79)
No
Does integrating pre-procedural cardiac CT with electro-anatomical mapping reduce VT recurrence and ICD shocks in patients with ischaemic heart disease undergoing catheter ablation?
Integrating pre-procedural cardiac CT with electro-anatomical mapping during VT ablation in patients with ischemic heart disease reduces ablation time and significantly lowers 1-year VT recurrence and ICD shocks.
Absolute Event Rate: 26% vs 44%
p-value: p=0.024
Abstract Background Catheter ablation is an effective therapy for ventricular tachycardia (VT) secondary to ischaemic heart disease (IHD) but its wider adoption is limited by procedure complexity and safety. Pre-procedural planning with cardiac computed tomography (CT) and its integration into electro-anatomical mapping (EAM) during ablation has sought to address some of the associated challenges. Purpose The aim of this study was to investigate the impact of integrating pre-procedural cardiac CT on VT catheter ablation outcomes in patients with IHD. Methods A retrospective study was performed on patients who underwent catheter ablation for VT secondary to ischaemic cardiomyopathy in our centre between 2015 and 2024. Procedure details and 1-year outcomes were compared between patients whose pre-procedural CT was or was not integrated with EAM during ablation. Results 79 patients were included, 54% with CT integration (n=43) and 46% without (n=36). All procedures were performed endocardially and all patients had implantable cardioverter-defibrillators (ICDs) at the time. PAINESD risk scores were similar (median 12 in both groups, p=0.317). Fluoroscopy dose and procedure time were similar in both groups but ablation time was reduced in procedures with CT integration (median 26.8 vs 30.6 mins, p=0.032). There was no difference in acute complications between groups. At 1 year, VT recurrence and incidence of ICD shock were reduced in the group with CT integration (26 vs 44%, log-rank p=0.024 and 14 vs 31%, log-rank p=0.037, respectively). Conclusions Integrating pre-procedural CT with EAM in VT ablation for patients with IHD reduced ablation time without increasing total procedure time. This more focussed ablation strategy was associated with a 1-year reduction in VT recurrence and ICD shocks.KM curves for VT-free survival at 1 year3D-reconstructed CT vs voltage map
Sammut et al. (Mon,) conducted a cohort in Ventricular tachycardia secondary to ischaemic heart disease (n=79). Integration of pre-procedural cardiac CT with electro-anatomical mapping vs. No CT integration was evaluated on Ventricular tachycardia recurrence at 1 year (p=0.024). Integrating pre-procedural cardiac CT with electro-anatomical mapping during VT ablation in patients with ischaemic heart disease reduced 1-year VT recurrence (26% vs 44%, p=0.024).