Noninvasive Programmed Ventricular Stimulation-Guided Management Following Ventricular Tachycardia Ablation

被引:13
作者
Muser, Daniele [1 ]
Hayashi, Tatsuya [1 ]
Castro, Simon A. [1 ]
Supple, Gregory E. [1 ]
Schaller, Robert D. [1 ]
Santangeli, Pasquale [1 ]
Arkles, Jeffrey [1 ]
Kumareswaran, Ramanan [1 ]
Nazarian, Saman [1 ]
Deo, Rajat [1 ]
Lin, David [1 ]
Dixit, Sanjay [1 ]
Epstein, Andrew E. [1 ]
Callans, David J. [1 ]
Marchlinski, Francis E. [1 ]
Frankel, David S. [1 ]
机构
[1] Univ Penn, Div Cardiovasc Med, Sect Cardiac Electrophysiol, Perelman Sch Med, Philadelphia, PA 19104 USA
关键词
catheter ablation; noninvasive programmed stimulation; ventricular tachycardia; CATHETER ABLATION; HEART-DISEASE; END-POINT; NONINDUCIBILITY; CARDIOMYOPATHY; PREDICT; IMPACT;
D O I
10.1016/j.jacep.2019.03.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES This study sought to determine the impact of repeat catheter ablation (CA) prior to hospital discharge based on inducibility of clinical ventricular tachycardia (VT) during noninvasive programmed ventricular stimulation (NIPS). BACKGROUND Inducibility of clinical VT during NIPS performed several days after CA identifies patients at high risk of recurrence. The impact of NIPS-guided repeat CA has not been reported. METHODS Consecutive patients with structural heart disease undergoing CA of VT followed by NIPS were studied. Clinical VT was defined by comparison with 12-lead electrocardiograms and stored implantable cardioverter-defibrillator etectrograms from spontaneous VT episodes. Among those with inducible clinical VT at MPS, VT-free survival was compared between those in whom ablation was repeated (group 1) versus those in whom ablation was not repeated (group 2) prior to hospital discharge. RESULTS Among 469 patients (64 12 years of age; 85% males; 60% ischemic), 216 patients (46%) underwent NIPS 3 days (interquartile range: 2 to 4 days) after CA. Clinical VT was induced in 45 patients (21%). Among those 45, CA was repeated in 11 patients (24%). There were no significant differences in baseline clinical or index CA characteristics between groups 1 and 2. Over a median 36-month follow-up, only 1 patient (9%) in group 1 experienced VT recurrence compared to 24 patients (71%) in group 2 (p < 0.01). In univariate Cox regression, repeat CA guided by NIPS (hazard ratio: 0.07; 95% confidence interval: 0.01 to 0.58; p 0.01) was the only predictor of VT-free survival. CONCLUSIONS In patients with inducible clinical VT during post-ablation NIPS, repeat CA was associated with significantly tower risk of subsequent recurrence. (C) 2019 by the American College of Cardiology Foundation.
引用
收藏
页码:719 / 727
页数:9
相关论文
共 22 条
[1]  
Al-Khatib Sana M, 2018, J Am Coll Cardiol, V72, pe91, DOI 10.1016/j.jacc.2017.10.054
[2]   Catheter ablation guided by termination of postinfarction ventricular tachycardia by pacing with nonglobal capture [J].
Bogun, F ;
Krishnan, SC ;
Marine, JE ;
Hohnloser, SH ;
Schuger, C ;
Oral, H ;
Pelosi, F ;
Chugh, A ;
Morady, F .
HEART RHYTHM, 2004, 1 (04) :422-426
[3]   Electroanatomic Substrate and Ablation Outcome for Suspected Epicardial Ventricular Tachycardia in Left Ventricular Nonischemic Cardiomyopathy [J].
Cano, Oscar ;
Hutchinson, Mathew ;
Lin, David ;
Garcia, Fermin ;
Zado, Erica ;
Bala, Rupa ;
Riley, Michael ;
Cooper, Joshua ;
Dixit, Sanjay ;
Gerstenfeld, Edward ;
Callans, David ;
Marchlinski, Francis E. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2009, 54 (09) :799-808
[4]   Reassessing Noninducibility as Ablation Endpoint of Post-Infarction Ventricular Tachycardia The Impact of Left Ventricular Function [J].
de Riva, Marta ;
Piers, Sebastiaan R. D. ;
Kapel, Gijs F. L. ;
Watanabe, Masaya ;
Venlet, Jeroen ;
Trines, Serge A. ;
Schalij, Martin J. ;
Zeppenfeld, Katja .
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2015, 8 (04) :853-862
[5]   Catheter Ablation of Ventricular Tachycardia and Mortality in Patients With Nonischemic Dilated Cardiomyopathy Can Noninducibility After Ablation Be a Predictor for Reduced Mortality? [J].
Dinov, Borislav ;
Arya, Arash ;
Schratter, Alexandra ;
Schirripa, Valentina ;
Fiedler, Lukas ;
Sommer, Philipp ;
Bollmann, Andreas ;
Rolf, Sascha ;
Piorkowski, Christopher ;
Hindricks, Gerhard .
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2015, 8 (03) :598-605
[6]   Noninvasive Programmed Ventricular Stimulation Early After Ventricular Tachycardia Ablation to Predict Risk of Late Recurrence [J].
Frankel, David S. ;
Mountantonakis, Stavros E. ;
Zado, Erica S. ;
Anter, Elad ;
Bala, Rupa ;
Cooper, Joshua M. ;
Deo, Rajat ;
Dixit, Sanjay ;
Epstein, Andrew E. ;
Garcia, Fermin C. ;
Gerstenfeld, Edward P. ;
Hutchinson, Mathew D. ;
Lin, David ;
Patel, Vickas V. ;
Riley, Michael P. ;
Robinson, Melissa R. ;
Tzou, Wendy S. ;
Verdino, Ralph J. ;
Callans, David J. ;
Marchlinski, Francis E. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2012, 59 (17) :1529-1535
[7]   Noninducibility in Postinfarction Ventricular Tachycardia as an End Point for Ventricular Tachycardia Ablation and Its Effects on Outcomes A Meta-Analysis [J].
Ghanbari, Hamid ;
Baser, Kazim ;
Yokokawa, Miki ;
Stevenson, William ;
Della Bella, Paolo ;
Vergara, Pasquale ;
Deneke, Thomas ;
Kuck, Karl-Heinz ;
Kottkamp, Hans ;
Fei, She ;
Morady, Fred ;
Bogun, Frank .
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2014, 7 (04) :677-+
[8]   Relationship of late potentials to the ventricular tachycardia circuit defined by entrainment [J].
Hsia, Henry H. ;
Lin, David ;
Sauer, William H. ;
Callans, David J. ;
Marchlinski, Francis E. .
JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY, 2009, 26 (01) :21-29
[9]   Endocardial Unipolar Voltage Mapping to Detect Epicardial Ventricular Tachycardia Substrate in Patients With Nonischemic Left Ventricular Cardiomyopathy [J].
Hutchinson, Mathew D. ;
Gerstenfeld, Edward P. ;
Desjardins, Benoit ;
Bala, Rupa ;
Riley, Michael P. ;
Garcia, Fermin C. ;
Dixit, Sanjay ;
Lin, David ;
Tzou, Wendy S. ;
Cooper, Joshua M. ;
Verdino, Ralph J. ;
Callans, David J. ;
Marchlinski, Francis E. .
CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY, 2011, 4 (01) :49-55
[10]   Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre randomised controlled trial [J].
Kuck, Karl-Heinz ;
Schaumann, Anselm ;
Eckardt, Lars ;
Willems, Stephan ;
Ventura, Rodolfo ;
Delacretaz, Etienne ;
Pitschner, Heinz-Friedrich ;
Kautzner, Josef ;
Schumacher, Burghard ;
Hansen, Peter S. .
LANCET, 2010, 375 (9708) :31-40