Author + information
- Pouria Alipour,
- Yaariv Khaykin,
- Zahra Azizi,
- Amirhossein Sharifzad,
- Despina Michailidis,
- Patrick Mallany,
- Evan Michaelov,
- Nikhil Nath,
- Alfredo Pantano and
- Atul Verma
Introduction: Radiofrequency catheter ablation has become mainstream treatment for Ventricular Tachycardia (VT) in patients with ischemic VT. VT is commonly induced at the beginning of the procedure to help identify and map the target. Many of these patients do not tolerate VT inductions. Advent of VT ablation targeting substrate may help avoid the need to perform a VT induction until after the ablation procedure has been completed. This study compared outcomes of patients who had pre-ablation VT-induction to those who did not.
Methods: Baseline and follow-up data for 74 consecutive patients (mean age: 52.8±12.7 years, 67.1% Male, 72% VT-I) with Ischemic cardiomyopathy who underwent VT ablation (VTA) between 2011-2016 at a single tertiary care center, were retrospectively collected, and included in the analysis. ECG, ambulatory monitoring, and ICD interrogation data were collected at 1, 3, 6, and 12 months post ablation. Any recurrence of VT was considered significant in the analysis. Patients were categorized as those who underwent pre-ablation induction (VT-I) vs those who did not (VT-NI).
Results: Overall 50% (58% VT-I, and 30% VT-NI, p=0.03) of the patients experienced recurrent VT post procedure. Patients with VT-NI prior to ablation had longer VT-free survival (4.1±0.6 years 95% CI: 3.02-5.01, p=0.021) compared to those with induction (2.8±0.6 years 95%CI: 1.74-3.88, p=0.04) (Figure 1). Additionally, 1 and 2-year survival for VT-I was lower compared to those with VT-NI (78.3%, and 71.8% vs. 59.5%, and 43.4% respectively, p=0.04). Average time to VT recurrence was 1.2±0.1 years for VT-I vs 2.3±0.5 for VT-NI (p=0.02).
Conclusions: Induction of VT prior to ablation is correlated with higher risk of recurrence and lower survival time for patients with Ischemic Cardiomyopathy. Further studies comparing the two approaches may be warranted.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Atrial Fibrillation and VT: Incorporating Novel Risks Toward Decision Making
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1280-104
- 2017 American College of Cardiology Foundation