Pre-procedural Image-guided Versus Non-image-guided Ventricular Tachycardia Ablation-a review

Overview

Journal Neth Heart J

Specialty Cardiology & Vascular Diseases

Date 2020 Sep 15

PMID 32930978

Citations 5

Authors

A A Hendriks

Z Kis

M Glisic

W M Bramer

T Szili-Torok

Affiliations

Soon will be listed here.

Abstract

Background: Magnetic resonance imaging and computed tomography in patients with ventricular tachycardia (VT) after myocardial infarction (MI) helps to delineate scar from healthy tissue. Image-guided VT ablation has not yet been studied on a large scale.

Objective: The aim of the meta-analysis was to compare the long-term outcome of image-guided VT ablation with a conventional approach for VT after MI.

Methods: Eight electronic bibliographic databases were searched to identify all relevant studies from 2012 until 2018. The search for scientific literature was performed for studies that described the outcome of VT ablation in patients with an ischaemic substrate. The outcome of image-guided ablation was compared with the outcome of conventional ablations.

Results: Of the 2990 citations reviewed for eligibility, 38 articles-enrolling a total of 7748 patients-were included into the meta-analysis. Five articles included patients with image-guided ablation. VT-free survival was 82% [74-90] in the image-guided VT ablation versus 59% [54-64] in the conventional ablation group (p < 0.001) during a mean follow-up of 35 months. Overall survival was 94% [90-98] in the image-guided versus 82% [76-88] in the conventional VT ablation group (p < 0.001).

Conclusions: Image-guided VT ablation in ischaemic VT was associated with a significant benefit in VT-free and overall survival as compared with conventional VT ablation. Visualising myocardial scar facilitates substrate-guided ablation procedures, pre-procedurally and by integrating imaging during the procedure, and may consequently improve long-term outcome.

Citing Articles

Predictors of long-term success after high-density mapping-guided substrate ablation procedures for ventricular tachycardia in patients with ischemic cardiomyopathy.

Balt J, Abeln B, van Dijk V, Wijffels M, Liebregts M, Boersma L J Arrhythm. 2024; 40(6):1442-1451.

PMID: 39669940 PMC: 11632252. DOI: 10.1002/joa3.13175.

High-resolution structural-functional substrate-trigger characterization: Future roadmap for catheter ablation of ventricular tachycardia.

Stoks J, Hermans B, Boukens B, Holtackers R, Gommers S, Kaya Y Front Cardiovasc Med. 2023; 10:1112980.

PMID: 36873402 PMC: 9978225. DOI: 10.3389/fcvm.2023.1112980.

Imaging Modality Selection in Cardiac Ablation.

Ngo C, Akoum N J Innov Card Rhythm Manag. 2022; 13(4):4968-4980.

PMID: 35521069 PMC: 9064504. DOI: 10.19102/icrm.2022.130402.

Cardiac Magnetic Resonance for Ventricular Tachycardia Ablation and Risk Stratification.

Roca-Luque I, Mont-Girbau L Front Cardiovasc Med. 2022; 8:797864.

PMID: 35097017 PMC: 8790056. DOI: 10.3389/fcvm.2021.797864.

Different road maps for ventricular tachycardia ablation.

Olde Nordkamp L, Boekholdt S, de Groot J Neth Heart J. 2020; 28(11):571-572.

PMID: 33079333 PMC: 7596152. DOI: 10.1007/s12471-020-01507-w.

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