Acute and long-term outcomes of VT radiofrequency catheter ablation in patients with versus without an intramural septal substrate
Introduction: Aim of this study was to evaluate efficacy and safety of ventricular tachycardia (VT) catheter ablation in patients with structural heart disease (SHD) in relation to the presence of an intramural septal substrate. Methods: Consecutive patients undergoing VT ablation between January 20...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
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Elsevier
2022-01-01
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| Series: | Indian Pacing and Electrophysiology Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0972629221001479 |
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| author | Philipp Halbfass Deborah Ludwig Kai Sonne Karin Nentwich Elena Ene Artur Berkovitz Borek Foldyna Sebastian Barth Julian Müller Lukas Lehmkuhl Ulrich Lüsebrink Christian Waechter Thomas Deneke |
| author_facet | Philipp Halbfass Deborah Ludwig Kai Sonne Karin Nentwich Elena Ene Artur Berkovitz Borek Foldyna Sebastian Barth Julian Müller Lukas Lehmkuhl Ulrich Lüsebrink Christian Waechter Thomas Deneke |
| author_sort | Philipp Halbfass |
| collection | DOAJ |
| description | Introduction: Aim of this study was to evaluate efficacy and safety of ventricular tachycardia (VT) catheter ablation in patients with structural heart disease (SHD) in relation to the presence of an intramural septal substrate. Methods: Consecutive patients undergoing VT ablation between January 2019 and October 2020 were included. All patients were stratified based on the presence of relevant septal substrate and freedom from VT recurrences were analyzed. Results: In total, 199 consecutive patients (64.2 ± 13.0 years; 89% male; 55% ischemic cardiomyopathy (ICM)) undergoing VT ablation were included. 129/199 patients (65%) showed significant septal substrate (55/90 patients (61%) with non-ischemic cardiomyopathy (NICM) compared to 74/109 patients (68%) with ICM; p = 0.37). Acute procedural success with elimination of all inducible VTs was achieved in 66/70 patients (94%) without and in 103/129 patients (80%) with a septal substrate (p = 0.007). In the cohort including patients with a clinical FU, 15/60 patients (25%) without a septal substrate and 48/123 patients (39%) with a septal substrate experienced VT recurrence during a FU of 8.1 ± 5.9 months (p = 0.069). Conclusion: Presence of septal VT substrate in patients with a structural heart disease or coronary artery disease is common. Acute success of VT catheter ablation was significantly higher and mid-term success tended to be higher in patients without a septal substrate. |
| first_indexed | 2024-04-11T18:13:52Z |
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| id | doaj.art-1de01e10e4824d23becca5029c56729c |
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| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-04-11T18:13:52Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
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| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-1de01e10e4824d23becca5029c56729c2022-12-22T04:09:58ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922022-01-0122129Acute and long-term outcomes of VT radiofrequency catheter ablation in patients with versus without an intramural septal substratePhilipp Halbfass0Deborah Ludwig1Kai Sonne2Karin Nentwich3Elena Ene4Artur Berkovitz5Borek Foldyna6Sebastian Barth7Julian Müller8Lukas Lehmkuhl9Ulrich Lüsebrink10Christian Waechter11Thomas Deneke12Clinic for Invasive Electrophysiology/Cardiology, Heart Center Bad Neustadt, Germany; Department of Cardiology and Angiology, Philipps-University Marburg, Germany; Corresponding author. Clinic for Invasive Electrophysiology, Heart Center Bad Neustadt, Von-Guttenberg-Strasse 11, 97616, Bad Neustadt a.d. Saale, Germany.Department of Cardiology and Angiology, Philipps-University Marburg, GermanyClinic for Invasive Electrophysiology/Cardiology, Heart Center Bad Neustadt, GermanyClinic for Invasive Electrophysiology/Cardiology, Heart Center Bad Neustadt, GermanyClinic for Invasive Electrophysiology/Cardiology, Heart Center Bad Neustadt, GermanyClinic for Invasive Electrophysiology/Cardiology, Heart Center Bad Neustadt, GermanyCardiovascular Imaging Research Center, Massachusetts General Hospital - Harvard Medical School, Boston, MA, USAClinic for Invasive Electrophysiology/Cardiology, Heart Center Bad Neustadt, GermanyClinic for Invasive Electrophysiology/Cardiology, Heart Center Bad Neustadt, Germany; Department of Cardiology and Angiology, Philipps-University Marburg, GermanyClinic for Radiology, Heart Center Bad Neustadt, GermanyDepartment of Cardiology and Angiology, Philipps-University Marburg, GermanyDepartment of Cardiology and Angiology, Philipps-University Marburg, GermanyClinic for Invasive Electrophysiology/Cardiology, Heart Center Bad Neustadt, GermanyIntroduction: Aim of this study was to evaluate efficacy and safety of ventricular tachycardia (VT) catheter ablation in patients with structural heart disease (SHD) in relation to the presence of an intramural septal substrate. Methods: Consecutive patients undergoing VT ablation between January 2019 and October 2020 were included. All patients were stratified based on the presence of relevant septal substrate and freedom from VT recurrences were analyzed. Results: In total, 199 consecutive patients (64.2 ± 13.0 years; 89% male; 55% ischemic cardiomyopathy (ICM)) undergoing VT ablation were included. 129/199 patients (65%) showed significant septal substrate (55/90 patients (61%) with non-ischemic cardiomyopathy (NICM) compared to 74/109 patients (68%) with ICM; p = 0.37). Acute procedural success with elimination of all inducible VTs was achieved in 66/70 patients (94%) without and in 103/129 patients (80%) with a septal substrate (p = 0.007). In the cohort including patients with a clinical FU, 15/60 patients (25%) without a septal substrate and 48/123 patients (39%) with a septal substrate experienced VT recurrence during a FU of 8.1 ± 5.9 months (p = 0.069). Conclusion: Presence of septal VT substrate in patients with a structural heart disease or coronary artery disease is common. Acute success of VT catheter ablation was significantly higher and mid-term success tended to be higher in patients without a septal substrate.http://www.sciencedirect.com/science/article/pii/S0972629221001479Ventricular tachycardiaSeptal substrateCatheter ablationEpicardial accessIschemic cardiomyopathyNon-ischemic cardiomyopathy |
| spellingShingle | Philipp Halbfass Deborah Ludwig Kai Sonne Karin Nentwich Elena Ene Artur Berkovitz Borek Foldyna Sebastian Barth Julian Müller Lukas Lehmkuhl Ulrich Lüsebrink Christian Waechter Thomas Deneke Acute and long-term outcomes of VT radiofrequency catheter ablation in patients with versus without an intramural septal substrate Indian Pacing and Electrophysiology Journal Ventricular tachycardia Septal substrate Catheter ablation Epicardial access Ischemic cardiomyopathy Non-ischemic cardiomyopathy |
| title | Acute and long-term outcomes of VT radiofrequency catheter ablation in patients with versus without an intramural septal substrate |
| title_full | Acute and long-term outcomes of VT radiofrequency catheter ablation in patients with versus without an intramural septal substrate |
| title_fullStr | Acute and long-term outcomes of VT radiofrequency catheter ablation in patients with versus without an intramural septal substrate |
| title_full_unstemmed | Acute and long-term outcomes of VT radiofrequency catheter ablation in patients with versus without an intramural septal substrate |
| title_short | Acute and long-term outcomes of VT radiofrequency catheter ablation in patients with versus without an intramural septal substrate |
| title_sort | acute and long term outcomes of vt radiofrequency catheter ablation in patients with versus without an intramural septal substrate |
| topic | Ventricular tachycardia Septal substrate Catheter ablation Epicardial access Ischemic cardiomyopathy Non-ischemic cardiomyopathy |
| url | http://www.sciencedirect.com/science/article/pii/S0972629221001479 |
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