Introduction
Methods
Study population
Procedural parameters
VT ablation procedure
Follow-up
Statistical analysis
Results
Patient characteristics
All | Anterior infarction | Inferior infarction | p value | |
---|---|---|---|---|
No. of patients | 152 | 64 | 88 | |
Men (%) | 139 (91%) | 56 (88%) | 83 (94%) | 0.14 |
Age, mean ± SD, years | 67 ± 9 | 67 ± 10 | 68 ± 9 | 0.47 |
CAD | ||||
1-Vessel | 21% | 28% | 15% | 0.11 |
2-Vessel | 28% | 28% | 28% | |
3-Vessel | 51% | 43% | 57% | |
CABG | 59 (39%) | 19 (30%) | 40 (46%) | 0.049 |
Ejection fraction, mean ± SD, % | 32 ± 10 | 28 ± 10 | 34 ± 10 | 0.001 |
No. of infarctions | ||||
1 | 81% | 81% | 82% | 0.994 |
2 | 16% | 16% | 16% | |
3 | 3% | 3% | 3% | |
Time from first infarct, mean ± SD, years | 18 ± 8 | 19 ± 10 | 17 ± 6 | 0.482 |
Time from last infarct, mean ± SD, years | 14 ± 10 | 15 ± 10 | 13 ± 9 | 0.351 |
NYHA class | ||||
I | 23% | 27% | 21% | 0.644 |
II | 53% | 50% | 56% | |
III | 22% | 20% | 23% | |
IV | 2% | 3% | 1% | |
Comorbidities | ||||
Hypertension | 83% | 78% | 86% | 0.2 |
Diabetes | 26% | 27% | 25% | 1.0 |
Atrial fibrillation | 43% | 45% | 42% | 0.74 |
GFR, mean ± SD, ml/min | 63 ± 26 | 67 ± 30 | 60 ± 23 | 0.09 |
ICD at present | 133 (88%) | 59 (92%) | 74 (84%) | 0.14 |
Time since ICD implantation, mean ± SD, years | 5.9 ± 4.5 | 6.2 ± 4.5 | 5.8 ± 4.5 | 0.578 |
Indication for ICD | ||||
Primary prevention | 33% | 36% | 40% | 0.72 |
Types of ICD | ||||
VVI | 41% | 46% | 47% | 0.1 |
DDD | 20% | 17% | 27% | |
CRT | 27% | 37% | 26% | |
Amiodarone | 65% | 72% | 60% | 0.13 |
Betablocker | 92% | 92% | 92% | 1.0 |
Procedural characteristics and acute outcome
All | Anterior infarct | Inferior infarct | p value | |
---|---|---|---|---|
Indication for procedure | ||||
Incessant VT/VT storm | 43% | 44% | 42% | 0.83 |
Frequent ICD therapies | 57% | 56% | 58% | |
VT at beginning of procedure | 10% | 9.4% | 10.2% | 0.94 |
Inducible VT | 97% | 100% | 94% | 0.08 |
Clinical VT | 65% | 45 (70%) | 53 (60%) | 0.24 |
Non-clinical VT | 72% | 48 (75%) | 61 (69%) | 0.59 |
No. of inducible VT | 2.8 ± 2 | 3.1 ± 2.2 | 2.6 ± 1.9 | 0.18 |
Clinical VT, CL in ms, mean ± SD | 412 ± 87 | 420 ± 84 | 407 ± 89 | 0.46 |
Access | ||||
Transseptal | 95% | 91% | 98% | 0.14 |
Retrograde | 5 (3.3%) | 4 (6.3%) | 1 (1.1%) | |
Epicardial | 3 (1.9%) | 2 (3.1%) | 1 (1.1%) | |
Activation map | 71% | 73% | 69% | 0.58 |
Procedure duration, mean ± SD, min | 192 ± 82 | 186 ± 67 | 196 ± 91 | 0.443 |
Time of RF delivery, mean ± SD, min | 23 ± 43 | 26 ± 61 | 21 ± 23 | 0.486 |
Fluoroscopy time, mean ± SD, min | 18.8 ± 10 | 19.4 ± 10.4 | 18.4 ± 9.8 | 0.543 |
No. of ablated VT, mean ± SD | 1.5 ± 0.9 | 1.6 ± 1.0 | 1.5 ± 0.8 | 0.59 |
Stimulation after ablationa | ||||
Complete success (no inducible VT) | 40% | 39% | 41% | 0.7 |
Partial success | 57% | 56% | 57% | |
Ablation failure (clinical VT still inducible) | 3.3% | 4.7% | 2.3% |