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Ventricular tachycardia ablation in structural heart disease: Impact of ablation strategy and non-inducibility as an end-point on long term outcome.

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  • معلومة اضافية
    • Subject Terms:
    • Author-Supplied Keywords:
      Catheter ablation
      Outcome
      Ventricular tachycardia
    • Abstract:
      Abstract Background To investigate the long term outcomes after catheter ablation (CA) of ventricular tachycardia (VT) in the context of structural heart disease in a multicenter cohort. The impact of different ablation strategies (substrate ablation versus activation guided versus combined) and non-inducibility as an end-point was evaluated. Methods Data was pooled from prospective registries at 5 centres over a 5 year period. Success was defined as survival free from recurrent ventricular arrhythmias (VA). Multivariate analysis of factors predicting survival free from VA was analysed by Cox regression. Results Five hundred sixty-six patients underwent CA for VT. Patients were 64 ± 15 years. Left ventricular ejection fraction was 35 ± 15% and 66% had ischaemic heart disease. At 2.3 (IQR 1.0–4.2) years, success was achieved in 44% after a single procedure, rising to 60% after repeat procedures. Mortality at final follow up was 22%. Multivariate analysis showed that higher left ventricular ejection fraction, younger age, ischaemic heart disease, and non-inducibility of VA predicted long term survival free from VA (all p < 0.05). There was no impact of the approach to ablation. Conclusion CA eliminates VT in a large proportion of patients long term. Ablation strategy did not impact outcome and hence substrate ablation is a reasonable initial strategy. Non-inducibility of VA predicted survival free from VA and may be worth pursuing as a procedural end-point. Highlights • Largest registries of structural VT ablations • Success was achieved in 45% after a single and 60% after repeat procedures. • The study demonstrates non-inducibility as a strong predictor of favourable outcome. [ABSTRACT FROM AUTHOR]
    • Abstract:
      Copyright of International Journal of Cardiology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
    • Author Affiliations:
      1The Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
    • ISSN:
      0167-5273
    • Accession Number:
      10.1016/j.ijcard.2018.08.099
    • Accession Number:
      134184602
  • Citations
    • ABNT:
      BREITENSTEIN, A. et al. Ventricular tachycardia ablation in structural heart disease: Impact of ablation strategy and non-inducibility as an end-point on long term outcome. International Journal of Cardiology, [s. l.], v. 277, p. 110–117, 2019. DOI 10.1016/j.ijcard.2018.08.099. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=134184602&custid=s8280428. Acesso em: 1 abr. 2020.
    • AMA:
      Breitenstein A, Sawhney V, Providencia R, et al. Ventricular tachycardia ablation in structural heart disease: Impact of ablation strategy and non-inducibility as an end-point on long term outcome. International Journal of Cardiology. 2019;277:110-117. doi:10.1016/j.ijcard.2018.08.099.
    • APA:
      Breitenstein, A., Sawhney, V., Providencia, R., Honarbakhsh, S., Ullah, W., Dhinoja, M. B., Schilling, R. J., Babu, G. G., Chow, A., Lambiase, P., Rajappan, K., Kalla, M., Cassar, M., Hall, M., Temple, I. P., Bartoletti, S., Panikker, S., Kontogeorgis, A., Wong, T., & Hunter, R. J. (2019). Ventricular tachycardia ablation in structural heart disease: Impact of ablation strategy and non-inducibility as an end-point on long term outcome. International Journal of Cardiology, 277, 110–117. https://doi.org/10.1016/j.ijcard.2018.08.099
    • Chicago/Turabian: Author-Date:
      Breitenstein, Alexander, Vinit Sawhney, Rui Providencia, Shohreh Honarbakhsh, Waqas Ullah, Mehul B. Dhinoja, Richard J. Schilling, et al. 2019. “Ventricular Tachycardia Ablation in Structural Heart Disease: Impact of Ablation Strategy and Non-Inducibility as an End-Point on Long Term Outcome.” International Journal of Cardiology 277 (February): 110–17. doi:10.1016/j.ijcard.2018.08.099.
    • Harvard:
      Breitenstein, A. et al. (2019) ‘Ventricular tachycardia ablation in structural heart disease: Impact of ablation strategy and non-inducibility as an end-point on long term outcome’, International Journal of Cardiology, 277, pp. 110–117. doi: 10.1016/j.ijcard.2018.08.099.
    • Harvard: Australian:
      Breitenstein, A, Sawhney, V, Providencia, R, Honarbakhsh, S, Ullah, W, Dhinoja, MB, Schilling, RJ, Babu, GG, Chow, A, Lambiase, P, Rajappan, K, Kalla, M, Cassar, M, Hall, M, Temple, IP, Bartoletti, S, Panikker, S, Kontogeorgis, A, Wong, T & Hunter, RJ 2019, ‘Ventricular tachycardia ablation in structural heart disease: Impact of ablation strategy and non-inducibility as an end-point on long term outcome’, International Journal of Cardiology, vol. 277, pp. 110–117, viewed 1 April 2020, .
    • MLA:
      Breitenstein, Alexander, et al. “Ventricular Tachycardia Ablation in Structural Heart Disease: Impact of Ablation Strategy and Non-Inducibility as an End-Point on Long Term Outcome.” International Journal of Cardiology, vol. 277, Feb. 2019, pp. 110–117. EBSCOhost, doi:10.1016/j.ijcard.2018.08.099.
    • Chicago/Turabian: Humanities:
      Breitenstein, Alexander, Vinit Sawhney, Rui Providencia, Shohreh Honarbakhsh, Waqas Ullah, Mehul B. Dhinoja, Richard J. Schilling, et al. “Ventricular Tachycardia Ablation in Structural Heart Disease: Impact of Ablation Strategy and Non-Inducibility as an End-Point on Long Term Outcome.” International Journal of Cardiology 277 (February 15, 2019): 110–17. doi:10.1016/j.ijcard.2018.08.099.
    • Vancouver/ICMJE:
      Breitenstein A, Sawhney V, Providencia R, Honarbakhsh S, Ullah W, Dhinoja MB, et al. Ventricular tachycardia ablation in structural heart disease: Impact of ablation strategy and non-inducibility as an end-point on long term outcome. International Journal of Cardiology [Internet]. 2019 Feb 15 [cited 2020 Apr 1];277:110–7. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=134184602&custid=s8280428