Contemporary Outcomes of Catheter Ablation of the Structural Ventricular Tachycardias in Severe Ischemic and Non-ischemic Cardiomyopathies in Turkish Population

Overview

Journal J Arrhythm

Publisher Wiley

Date 2024 Dec 13

PMID 39669922

Authors

Emir Baskovski

Timucin Altin

Omer Akyurek

Mahmut Ekrem Cunetoglu

Volkan Kozluca

Irem Muge Akbulut

Nail Burak Ozbeyaz

Nazli Turan Serifler

Eralp Tutar

Affiliations

Soon will be listed here.

Abstract

Introduction: Currently, there are no data regarding outcomes of the catheter ablation for structural ventricular tachycardia (VT) in Türkiye. In this observational study, we aim to investigate cardiac outcomes of patients undergoing catheter VT ablation at a tertiary center in Türkiye.

Methods: This was a retrospective observational study performed at a single university center. Patients with a confirmed ischemic or non-ischemic cardiomyopathy, undergoing structural VT ablation were included. Procedural and mid-term outcomes were analyzed.

Results: A total of 124 patients were enrolled in the study. 54(43.5%) patients presented with an electrical storm. During the mean follow-up of 351 ± 232 days 10(8.1%) patients experienced a recurrence. There was only one peri-procedural death and cardiac tamponade occurred in two patients.14(11.3%) patients died during the follow-up, most commonly due to a cardiovascular death. In the multivariate analysis only age >70 was found to be correlated with death during follow-up, with =.008, HR = 4.923.

Conclusion: A good acute success with low complications was observed in patients undergoing VT ablation for structural heart disease in a tertiary center in Türkiye. Mid-term outcomes are comparable with international studies with no difference in VT recurrence in ischemic and non-ischemic patients. Similar to international studies, significant mid-term mortality was observed.

References

Tilz R, Lin T, Eckardt L, Deneke T, Andresen D, Wieneke H . Ablation Outcomes and Predictors of Mortality Following Catheter Ablation for Ventricular Tachycardia: Data From the German Multicenter Ablation Registry. J Am Heart Assoc. 2018; 7(6). PMC: 5907539. DOI: 10.1161/JAHA.117.007045. View

Yousuf O, Zusterzeel R, Sanders W, Canos D, Dekmezian C, Silverman H . Trends and Outcomes of Catheter Ablation for Ventricular Tachycardia in a Community Cohort. JACC Clin Electrophysiol. 2018; 4(9):1189-1199. DOI: 10.1016/j.jacep.2018.06.020. View

Bhaskaran A, FitzGerald J, Jackson N, Gizurarson S, Nanthakumar K, Porta-Sanchez A . Decrement Evoked Potential Mapping to Guide Ventricular Tachycardia Ablation: Elucidating the Functional Substrate. Arrhythm Electrophysiol Rev. 2021; 9(4):211-218. PMC: 7788395. DOI: 10.15420/aer.2020.25. View

Shirai Y, Liang J, Santangeli P, Arkles J, Schaller R, Supple G . Comparison of the Ventricular Tachycardia Circuit Between Patients With Ischemic and Nonischemic Cardiomyopathies: Detailed Characterization by Entrainment. Circ Arrhythm Electrophysiol. 2019; 12(7):e007249. DOI: 10.1161/CIRCEP.119.007249. View

Tung R, Vaseghi M, Frankel D, Vergara P, Di Biase L, Nagashima K . Freedom from recurrent ventricular tachycardia after catheter ablation is associated with improved survival in patients with structural heart disease: An International VT Ablation Center Collaborative Group study. Heart Rhythm. 2015; 12(9):1997-2007. PMC: 4549209. DOI: 10.1016/j.hrthm.2015.05.036. View

Kanagaratnam A, Virk S, Pham T, Anderson R, Turnbull S, Campbell T . Catheter Ablation for Ventricular Tachycardia in Ischaemic Versus Non-Ischaemic Cardiomyopathy: A Systematic Review and Meta-Analysis. Heart Lung Circ. 2022; 31(8):1064-1074. DOI: 10.1016/j.hlc.2022.02.014. View

Ding W, Pearman C, Bonnett L, Adlan A, Chin S, Denham N . Complication rates following ventricular tachycardia ablation in ischaemic and non-ischaemic cardiomyopathies: a systematic review. J Interv Card Electrophysiol. 2021; 63(1):59-67. PMC: 8755671. DOI: 10.1007/s10840-021-00948-6. View

Della Bella P, Baratto F, Vergara P, Bertocchi P, Santamaria M, Notarstefano P . Does Timing of Ventricular Tachycardia Ablation Affect Prognosis in Patients With an Implantable Cardioverter Defibrillator? Results From the Multicenter Randomized PARTITA Trial. Circulation. 2022; 145(25):1829-1838. DOI: 10.1161/CIRCULATIONAHA.122.059598. View

Sciria C, Kogan E, Ip J, Thomas G, Liu C, Markowitz S . Trends and Outcomes of Catheter Ablation of Ventricular Tachycardia in Patients With Ischemic and Nonischemic Cardiomyopathy. Circ Arrhythm Electrophysiol. 2022; 15(4):e010742. DOI: 10.1161/CIRCEP.121.010742. View

10.

Aziz Z, Shatz D, Raiman M, Upadhyay G, Beaser A, Besser S . Targeted Ablation of Ventricular Tachycardia Guided by Wavefront Discontinuities During Sinus Rhythm: A New Functional Substrate Mapping Strategy. Circulation. 2019; 140(17):1383-1397. DOI: 10.1161/CIRCULATIONAHA.119.042423. View

11.

Guerra F, Shkoza M, Scappini L, Flori M, Capucci A . Role of electrical storm as a mortality and morbidity risk factor and its clinical predictors: a meta-analysis. Europace. 2013; 16(3):347-53. DOI: 10.1093/europace/eut304. View

12.

Tung R, Xue Y, Chen M, Jiang C, Shatz D, Besser S . First-Line Catheter Ablation of Monomorphic Ventricular Tachycardia in Cardiomyopathy Concurrent With Defibrillator Implantation: The PAUSE-SCD Randomized Trial. Circulation. 2022; 145(25):1839-1849. DOI: 10.1161/CIRCULATIONAHA.122.060039. View

13.

BIGGER Jr J, Fleiss J, KLEIGER R, Miller J, Rolnitzky L . The relationships among ventricular arrhythmias, left ventricular dysfunction, and mortality in the 2 years after myocardial infarction. Circulation. 1984; 69(2):250-8. DOI: 10.1161/01.cir.69.2.250. View

14.

Irie T, Yu R, Bradfield J, Vaseghi M, Buch E, Ajijola O . Relationship between sinus rhythm late activation zones and critical sites for scar-related ventricular tachycardia: systematic analysis of isochronal late activation mapping. Circ Arrhythm Electrophysiol. 2015; 8(2):390-9. PMC: 4695215. DOI: 10.1161/CIRCEP.114.002637. View