Acute and long-term outcomes of VT radiofrequency catheter ablation in patients with versus without an intramural septal substrate: VT-patients With Septal Substrate

• Main Authors: Barth, S. (Author), Berkovitz, A. (Author), Deneke, T. (Author), Ene, E. (Author), Foldyna, B. (Author), Halbfass, P. (Author), Lehmkuhl, L. (Author), Ludwig, D. (Author), Lüsebrink, U. (Author), Müller, J. (Author), Nentwich, K. (Author), Sonne, K. (Author), Waechter, C. (Author)
• Format: Article
• Language: English
• Published: Indian Pacing and Electrophysiology Group 2022
• Subjects: adult; aged; amiodarone; anticoagulant agent; Article; cardiomyopathy; Catheter ablation; cohort analysis; comparative study; congestive cardiomyopathy; continuous infusion; controlled study; coronary artery disease; Epicardial access; epicardium mapping; female; gadolinium; heart disease; heart function; heart left ventricle ejection fraction; heart ventricle tachycardia; human; hypertension; hypertrophic cardiomyopathy; hypertrophic obstructive cardiomyopathy; interventricular septum; ischemic cardiomyopathy; Ischemic cardiomyopathy; late gadolinium enhancement imaging; major clinical study; male; morphine derivative; myotonic dystrophy; nonischemic cardiomyopathy; Non-ischemic cardiomyopathy; nuclear magnetic resonance imaging; pericardiocentesis; pleura cavity; prevalence; prognosis; propofol; radiofrequency catheter ablation; sarcoidosis; second degree atrioventricular block; Septal substrate; Ventricular tachycardia
• Online Access: View Fulltext in Publisher
• Physical Description: 8
• ISBN: 09726292 (ISSN)
• DOI: 10.1016/j.ipej.2021.10.002

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. © 2021 Indian Heart Rhythm Society