SPC365

Long-Term outcome of ventricular tachycardia catheter ablation in ischemic heart disease patients using a high-density mapping substrate-based approach: a prospective cohort study.

Session: CO 16 - Morte Súbita
Speaker: Tiago Graça Rodrigues

Congress: CPC 2021
Topic: C. Arrhythmias and Device Therapy
Theme: 08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme: 08.4 Ventricular Arrhythmias and SCD - Treatment
Session Type: Comunicações Orais
FP Number: ---
Authors: Tiago Graça Rodrigues; Gustavo Lima da Silva; Afonso Nunes-Ferreira; Nelson Cunha; Pedro Silvério António; Sara Pereira; Joana Brito; Pedro Alves da Silva; Beatriz Valente Silva; Ana Bernardes; Luís Carpinteiro; Nuno Cortez-Dias; Professor Doutor Fausto j. Pinto; João de Sousa

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;"><span style="color:#000000"><strong><u><span style="font-size:10pt"><span style="font-family:Calibri">Introduction and objective:</span></span></u></strong><span style="font-size:10pt"><span style="font-family:Calibri"><span style="color:#111111">Radiofrequency catheter ablation (RCA) for ventricular tachycardia (VT) in patients with ischemic heart disease (IHD) is associated with a reduced risk of VT storm and implantable cardioverter defibrillator (ICD) shocks. </span></span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;"><span style="color:#000000"><strong><u><span style="font-size:10pt"><span style="font-family:Calibri"><span style="color:#111111">Aim:</span></span></span></u></strong><span style="font-size:10pt"><span style="font-family:Calibri"><span style="color:#111111">to report the long-term outcome </span></span></span><span style="font-size:10pt"><span style="font-family:Calibri"><span style="color:#101010">after a single RCA procedure for VT in patients with IHD using a </span></span></span><span style="font-size:10pt"><span style="font-family:Calibri"><span style="color:#111111">high-density substrate-based approach.</span></span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;"><span style="color:#000000"><strong><u><span style="font-size:10pt"><span style="font-family:Calibri">Methods</span></span></u></strong><strong><span style="font-size:10pt"><span style="font-family:Calibri">: </span></span></strong><span style="font-size:10pt"><span style="font-family:Calibri">We conducted a </span></span><span style="font-size:10pt"><span style="font-family:Calibri">prospective, observational, single-centre and single-arm study involving patients with IHD, referred for RCA procedure for VT using high-density mapping catheters. Substrate mapping was performed in all patients. Procedural endpoints were VT noninducibility and local abnormal ventricular activities (LAVAs) elimination. The primary end point was survival free from appropriate ICD shocks and secondary end points included VT storm and all-cause mortality.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;"><span style="color:#000000"><strong><u><span style="font-size:10pt"><span style="font-family:Calibri">Results</span></span></u></strong><strong><span style="font-size:10pt"><span style="font-family:Calibri">: </span></span></strong><span style="font-size:10pt"><span style="font-family:Calibri">Sixty-four consecutive patients were included (68&plusmn;9 years, 95% male, mean ejection fraction 33&plusmn;11% , 39% VT storms, and 69% appropriate ICD shocks). LAVAs were identified in all patients and VT inducibility was found in 83%. </span></span><span style="font-size:10pt"><span style="font-family:Calibri">LAVAs elimination and noninducibility</span></span><span style="font-size:10pt"><span style="font-family:Calibri">were achieved in 93.8% and 60%, respectively. After a mean follow-up of </span></span><span style="font-size:10pt"><span style="font-family:Calibri">25&plusmn;18 months, </span></span><span style="font-size:10pt"><span style="font-family:Calibri"><span style="color:black">90% and 85% of patients are free from appropriate ICD shocks at 1 and 2 years, respectively. </span></span></span><span style="font-size:10pt"><span style="font-family:Calibri">The proportion of patients experiencing VT storm decreased from 39% to 1.6%. </span></span><span style="font-size:10pt"><span style="font-family:Calibri">Overall survival was 89% and 84% at 1 and 2 years, respectively.</span></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:&quot;Times New Roman&quot;"><span style="color:#000000"><strong><u><span style="font-size:10pt"><span style="font-family:Calibri">Conclusions:</span></span></u></strong><span style="font-size:10pt"><span style="font-family:Calibri">RCA of VT in IHD using a high-density mapping substrate-based approach </span></span><span style="font-size:10pt"><span style="font-family:Calibri"><span style="color:#111111">resulted in a long-term steady freedom of ICD shocks and VT storm.</span></span></span></span></span></span></p>