Journal of Arrhythmia (Feb 2015)

Long-term outcomes of catheter ablation of ventricular tachycardia in patients with structural heart disease

  • Masahiko Goya, MD,
  • Masato Fukunaga, MD,
  • Ken-ichi Hiroshima, MD,
  • Kentaro Hayashi, MD,
  • Yu Makihara, MD,
  • Michio Nagashima, MD,
  • Yoshimori An, MD,
  • Seiji Ohe, MD,
  • Kennosuke Yamashita, MD,
  • Kenji Ando, MD,
  • Hiroyoshi Yokoi, MD,
  • Masashi Iwabuchi, MD,
  • Kouji Katayama,
  • Tomoaki Ito,
  • Harushi Niu

DOI
https://doi.org/10.1016/j.joa.2014.06.001
Journal volume & issue
Vol. 31, no. 1
pp. 22 – 28

Abstract

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Background: Catheter ablation of ventricular tachycardia (VT) is feasible. However, the long-term outcomes for different underlying diseases have not been well defined. Methods: Eighty-eight consecutive patients who underwent catheter ablation of VT using a three-dimensional mapping system were analyzed. The primary endpoint was any VT or ventricular fibrillation (VF) recurrence. Secondary endpoints were a composite of death or any VT/VF recurrence. Underlying heart diseases were remote myocardial infarction (remote MI) in 51 patients and non-ischemic cardiomyopathy in 37 (arrhythmogenic right ventricular cardiomyopathy [ARVC] in 18 patients, and dilated cardiomyopathy [NIDCM] in 19). Results: Acute success was achieved in 82 of 88 (93%) patients. During a follow-up period of 39.2±4.6 months, VT recurred in 26 of 87 (30%), and VT/VF recurrence or death occurred in 39 of 87 (45%) patients. ARVC had better outcomes than NIDCM for the primary (p<0.05) and secondary endpoints (p<0.05). Remote MI-VT revealed a midrange outcome. Conclusions: The long-term outcomes after catheter ablation of VT varied according to the underlying heart disease. ARVC-VT ablation was associated with better long-term prognosis than NIDCM. Remote MI-VT demonstrated a midrange outcome.

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