Abstract：
OBJECTIVES:The purpose of this study was to assess the long-term effects of ablation of infarct-related ventricular tachycardia (VT) and the subsequent requirement for implantable cardioverter-defibrillator (ICD) therapy. BACKGROUND:The long-term consequences after initially successful catheter ablation of infarct-related VT remain unclear. METHODS:Forty patients who presented with infarct-related VT were studied using noncontact mapping to guide ablation. RESULTS:One hundred forty VTs were mapped using the noncontact mapping system, including 36 (25.7%) clinical VTs. An endocardial exit site was determined in 100% of VT circuits, diastolic endocardial activity in 77 VTs (55%), and complete circuits in 24 VTs (17.1%). Eighty-one VTs (57.9%) were targeted for ablation, of which 67 (82.7% of targeted) were successfully ablated, including 27 clinical VTs (75% of clinical). Documented recurrence of an ablated VT occurred in 7.5% of patients over 36.3 +/- 21.0 months of follow-up. Episodes of new or recurrent, nontargeted VT or ventricular fibrillation (VF) occurred in 37.5% and VT recurrence without documentation of cycle length in 5%. In patients with ICDs, mean shock frequency was reduced from 6.8 +/- 7.3 per month in the year prior to ablation to 0.05 +/- 0.12 per month after ablation, over 24.7 +/- 18.9 months of follow-up (P < .0001). CONCLUSIONS:In patients with infarct-related VT, noncontact mapping-guided VT ablation is associated with a high procedural success rate, and VT recurrence necessitating ICD therapy delivery is significantly reduced. However, only 42.5% of patients remain free from VT/VF 3 years after ablation. Catheter ablation for infarct-related VT is indicated as an adjunctive therapy in patients with symptomatic VT but cannot substitute for ICDs and antiarrhythmic drugs.
journal_name
Heart Rhythmjournal_title
Heart rhythmauthors
Segal OR,Chow AW,Markides V,Schilling RJ,Peters NS,Davies DWdoi
10.1016/j.hrthm.2005.01.017keywords:
subject
Has Abstractpub_date
2005-05-01 00:00:00pages
474-82issue
5eissn
1547-5271issn
1556-3871pii
S1547-5271(05)00188-8journal_volume
2pub_type
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