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2021-02-24

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cc-by (c), Quinto, Levio et al., 2021
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/185184

Ventricular tachycardia burden reduction after substrate ablation: predictors of recurrence.

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Recurs relacionat

https://doi.org/10.1016/j.hrthm.2021.02.016

Resum

BACKGROUND Substrate-based ventricular tachycardia (VT) ablation is a first-line treatment in patients with structural cardiac disease and sustained VT refractory to medical therapy. Despite technological improvements and increased knowledge of VT substrate, recurrence still is frequent. Published data are lacking on the possible reduction in VT burden after ablation despite recurrence. OBJECTIVE The purpose of this study was to assess VT burden reduction during long-term follow-up after substrate ablation and identify predictors of VT recurrence. METHODS We analyzed 234 consecutive VT ablation procedures in 207 patients (age 63 6 14.9 years; 92% male; ischemic heart disease in 65%) who underwent substrate ablation in a single center from 2013 to 2018. RESULTS After follow-up of 3.14 6 1.8 years, the VT recurrence rate was 41.4%. Overall, a 99.6% reduction in VT burden (median VT episodes per year: preprocedural 3.546 [1.347-13.951] vs postprocedural 0.001 [0-0.689]; P 5 .001) and a 96.3% decrease in implantable cardioverter-defibrillator (ICD) shocks (preprocedural 1.145 [0.118-4.467] vs postprocedural 0.042 [0-0.111] per year; P 5 .017) were observed. In the subgroup of patients who experienced VT recurrences, VT burden decreased by 69.2% (median VT episodes per year: preprocedural 2.876 [1.105-8.801] vs postprocedural 0.882 [0.505-2.283]; P ,.001). Multivariable analysis showed persistence of late potentials (67% vs 19%; hazard ratio 3.18 [2.18- 6.65]; P ,.001) and lower left ventricular ejection fraction (EF) (30 [25-40] vs 39 [30-50]; P 5 .022) as predictors of VT recurrence. CONCLUSION Despite a high recurrence rate during long-term follow-up, substrate-based VT ablation is related to a large reduction in VT burden and a decrease in ICD therapies. Lower EF and persistence of late potentials are predictors of recurrence. KEYWORDS Arrhythmic burden reduction; Implantable cardioverter-defibrillator shock prevention; Ventricular tachycardia ablation; Ventricular tachycardia recurrence predictors; Ventricular tachycardia storm; Ventricular tachycardia substrate ablation

Matèries

Taquicàrdia, Desfibril·ladors cardioversors implantables, Malalts cardíacs

Matèries (anglès)

Tachycardia, Implantable cardioverter-defibrillators, Cardiac patients

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

QUINTO, Levio, SANCHEZ SOMONTE, Paula, ALARCÓN, Francisco, GARRE, Paz, CASTILLO, Àngel, SAN ANTONIO, Rodolfo, BORRÀS, Roger, GUASCH I CASANY, Eduard, ARBELO, Elena, TOLOSANA, José m. (josé maría), BERRUEZO SÁNCHEZ, Antonio, MONT GIRBAU, Lluís, ROCA LUQUE, Ivo. Ventricular tachycardia burden reduction after substrate ablation: predictors of recurrence.. _Heart Rhythm_. 2021. Vol. 18, núm. 6, pàgs. 896-904. [consulta: 28 de gener de 2026]. ISSN: 1547-5271. [Disponible a: https://hdl.handle.net/2445/185184]

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