Long-term success of irrigated radiofrequency catheter ablation of sustained ventricular tachycardia

May 06, 2016 , Category : Cardiology Abstracts

Long-term success of irrigated radiofrequency catheter ablation of sustained ventricular tachycardia

Marchlinski et al (J Am Coll Cardiol 2016;67:674, PMID 26868693) evaluated the safety and effectiveness of radiofrequency catheter ablation using an open-irrigated catheter. Patients with sustained monomorphic ventricular tachycardia (SMVT) and coronary disease were analyzed for adverse events within 7 days, hospitalization duration, SMVT recurrence, quality of life, long-term (3-year) survival, symptomatic VT control, and amiodarone (Amio) use. In the 249 patients enrolled, the adverse event rate was 3.9% (9 of 233). Noninducibility of targeted VT was achieved in 75.9% of patients. At 6 months, 62.0% (114 of 184) of patients had no SMVT recurrence. The proportion of patients with implantable cardioverter-defibrillator (ICD) shocks decreased from 81.2% to 26.8% (P < .0001). Patient-reported VT remained steady for 1, 2, and 3 years at 22.7%, 29.8%, and 24.1%, respectively. Amio use and hospitalization decreased from 55% and 77.2% preablation to 23.3% and 30.7%, 18.5% and 36.7%, 17.7% and 31.3% at 1, 2, and 3 years, respectively. The authors conclude that radiofrequency catheter ablation reduced ICD shocks and VT episodes and improved quality of life at 6 months and that the 3-year nonrecurrence rate with reduced Amio use and hospitalizations indicate improved long-term outcomes.


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