Long-term Outcomes of Catheter Ablation for Ventricular Arrhythmias: Comparing Techniques with and Without Intracardiac Echocardiography - What Matters?

Overview

Journal BMC Cardiovasc Disord

Publisher Biomed Central

Specialty Cardiology & Vascular Diseases

Date 2024 Jul 26

PMID 39061011

Authors

Mingjie Lin

Chuanzhen Ma

Bing Rong

Kai Zhang

Tongshuai Chen

Juntao Wang

Wenqiang Han

Jingquan Zhong

Lin Wu

Affiliations

Soon will be listed here.

Abstract

Background: The increasing use of intracardiac echocardiography (ICE) in the ablation of premature ventricular complexes (PVCs) has raised questions about its true efficacy and safety.

Methods: This retrospective study collected the periprocedural complications and PVC burden post ablation. The risk factors of PVC recurrence was further explored.

Results: The study included patients treated without ICE (control group, n = 451) and with ICE (ICE group, n = 155) from May 2019 to July 2022. The ICE group demonstrated significantly lower fluoroscopy times and X-ray doses. There were no major complications in the ICE group, and the difference in the occurrence of periprocedural complications between the groups was not statistically significant (p = 0.072). The long-term success rates were similar for the control and ICE groups (89.6% and 87.1%, respectively). The origin of PVCs was identified as the independent factor for ablation success.

Conclusions: The use of ICE did not confer an advantage with regard to long-term success in PVCs ablation. To thoroughly evaluate the safety and effectiveness of ICE in PVCs ablation, a prospective, multicenter, randomized study is warranted.

Citing Articles

Ventricular premature beats in a pregnant woman originating from trabeculae carneae in the right ventricle treated with radiofrequency ablation without X-ray guidance: a case report.

Li T, Li X, Zhou L, Hassan M, Yang Z J Med Case Rep. 2024; 18(1):587.

PMID: 39614395 PMC: 11607976. DOI: 10.1186/s13256-024-04951-z.

References

Wang Y, Zhao Y, Zhou K, Zei P, Wang Y, Cheng H . Intracardiac echocardiography is a safe and effective alternative to transesophageal echocardiography for left atrial appendage thrombus evaluation at the time of atrial fibrillation ablation: The ICE-TEE study. Pacing Clin Electrophysiol. 2022; 46(1):3-10. DOI: 10.1111/pace.14601. View

Alqarawi W, Ramirez F, Nery P, Redpath C, Sadek M, Green M . Identifying and Managing Premature Ventricular Contraction-Induced Cardiomyopathy: What, Why, and How?. Can J Cardiol. 2016; 33(2):287-290. DOI: 10.1016/j.cjca.2016.06.010. View

Yamagami S, Mori S, Nishiuchi S, Akiyama M, Nakano Y, Kondo H . Successful Supravalvular Radiofrequency Catheter Ablation of Premature Ventricular Contractions Originating From the Left Ventricular Summit. JACC Clin Electrophysiol. 2023; 10(2):405-413. DOI: 10.1016/j.jacep.2023.10.003. View

Lei M, Wu L, Terrar D, Huang C . Modernized Classification of Cardiac Antiarrhythmic Drugs. Circulation. 2018; 138(17):1879-1896. DOI: 10.1161/CIRCULATIONAHA.118.035455. View

Zhong L, Lee Y, Huang X, Asirvatham S, Shen W, Friedman P . Relative efficacy of catheter ablation vs antiarrhythmic drugs in treating premature ventricular contractions: a single-center retrospective study. Heart Rhythm. 2013; 11(2):187-93. DOI: 10.1016/j.hrthm.2013.10.033. View

Mountantonakis S, Frankel D, Gerstenfeld E, Dixit S, Lin D, Hutchinson M . Reversal of outflow tract ventricular premature depolarization-induced cardiomyopathy with ablation: effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome. Heart Rhythm. 2011; 8(10):1608-14. DOI: 10.1016/j.hrthm.2011.04.026. View

Rubesch-Kutemeyer V, Fischbach T, Guckel D, Korber B, Horstkotte D, Gutleben K . Long-term development of radiation exposure, fluoroscopy time and contrast media use in daily routine in cryoballoon ablations after implementation of intracardiac echocardiography and other radioprotective measures: experiences from a large.... J Interv Card Electrophysiol. 2019; 58(2):169-175. DOI: 10.1007/s10840-019-00564-5. View

Hua W, Gao R, Zhao B, Wang J, Chen X, Cai C . The Efficacy and Safety of Wenxin Keli in Patients with Frequent Premature Ventricular Contractions: A Randomized, Double-blind, Placebo-controlled, Parallel-group, Multicenter Trial. Chin Med J (Engl). 2015; 128(19):2557-64. PMC: 4736861. DOI: 10.4103/0366-6999.166026. View

Lin A, Shirai Y, Liang J, Chen S, Kochar A, Hyman M . Strategies for Catheter Ablation of Left Ventricular Papillary Muscle Arrhythmias: An Institutional Experience. JACC Clin Electrophysiol. 2020; 6(11):1381-1392. DOI: 10.1016/j.jacep.2020.06.026. View

10.

Jingquan Z, Deyong L, Huimin C, Hua F, Xuebin H, Chenyang J . Intracardiac echocardiography Chinese expert consensus. Front Cardiovasc Med. 2022; 9:1012731. PMC: 9584059. DOI: 10.3389/fcvm.2022.1012731. View

11.

Kitamura T, Nakajima M, Kawamura I, Kaszynski R, Ohbe H, Sasabuchi Y . Safety and effectiveness of intracardiac echocardiography in ventricular tachycardia ablation: a nationwide observational study. Heart Vessels. 2021; 36(7):1009-1015. DOI: 10.1007/s00380-020-01766-y. View

12.

Field M, Gold M, Reynolds M, Goldstein L, Yu Lee S, Kalsekar I . Real-world outcomes of ventricular tachycardia catheter ablation with versus without intracardiac echocardiography. J Cardiovasc Electrophysiol. 2019; 31(2):417-422. DOI: 10.1111/jce.14324. View

13.

Rivera S, Vecchio N, Ricapito P, Ayala-Paredes F . Non-fluoroscopic catheter ablation of arrhythmias with origin at the summit of the left ventricle. J Interv Card Electrophysiol. 2019; 56(3):279-290. DOI: 10.1007/s10840-019-00522-1. View

14.

Al-Khatib S, Stevenson W, Ackerman M, Bryant W, Callans D, Curtis A . 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and.... Heart Rhythm. 2017; 15(10):e73-e189. DOI: 10.1016/j.hrthm.2017.10.036. View

15.

Latchamsetty R, Yokokawa M, Morady F, Kim H, Mathew S, Tilz R . Multicenter Outcomes for Catheter Ablation of Idiopathic Premature Ventricular Complexes. JACC Clin Electrophysiol. 2018; 1(3):116-123. DOI: 10.1016/j.jacep.2015.04.005. View

16.

Ma C, Chen T, Chen Y, Ge J, Han W, Wang Q . Understanding the scope of intracardiac echocardiography in catheter ablation of ventricular arrhythmia. Front Cardiovasc Med. 2022; 9:1037176. PMC: 9650380. DOI: 10.3389/fcvm.2022.1037176. View

17.

Wijnmaalen A, Delgado V, Schalij M, van Huls van Taxis C, Holman E, Bax J . Beneficial effects of catheter ablation on left ventricular and right ventricular function in patients with frequent premature ventricular contractions and preserved ejection fraction. Heart. 2010; 96(16):1275-80. DOI: 10.1136/hrt.2009.188722. View

18.

van Huls van Taxis C, Piers S, Silva M, Dekkers O, Pijnappels D, Schalij M . Fatigue as Presenting Symptom and a High Burden of Premature Ventricular Contractions Are Independently Associated With Increased Ventricular Wall Stress in Patients With Normal Left Ventricular Function. Circ Arrhythm Electrophysiol. 2015; 8(6):1452-9. DOI: 10.1161/CIRCEP.115.003091. View

19.

Wang X, Hu D, Dang S, Huang H, Huang C, Yuan M . Effects of Traditional Chinese Medicine Shensong Yangxin Capsules on Heart Rhythm and Function in Congestive Heart Failure Patients with Frequent Ventricular Premature Complexes: A Randomized, Double-blind, Multicenter Clinical Trial. Chin Med J (Engl). 2017; 130(14):1639-1647. PMC: 5520549. DOI: 10.4103/0366-6999.209906. View

20.

Gulletta S, Gasperetti A, Schiavone M, Paglino G, Vergara P, Compagnucci P . Long-Term Follow-Up of Catheter Ablation for Premature Ventricular Complexes in the Modern Era: The Importance of Localization and Substrate. J Clin Med. 2022; 11(21). PMC: 9654324. DOI: 10.3390/jcm11216583. View