Stable and unstable ventricular tachycardias in patients with previous myocardial infarction: a clinically oriented strategy for catheter ablation
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Stable and unstable ventricular tachycardias in patients with previous myocardial infarction: a clinically oriented strategy for catheter ablation. / Ventura, Rodolfo; Klemm, Hanno U; Rostock, Thomas; Lutomsky, Boris; Risius, Tim; Steven, Daniel; Weiss, Christian; Meinertz, Thomas; Willems, Stephan.
in: CARDIOLOGY, Jahrgang 109, Nr. 1, 2008, S. 52-61.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Stable and unstable ventricular tachycardias in patients with previous myocardial infarction: a clinically oriented strategy for catheter ablation
AU - Ventura, Rodolfo
AU - Klemm, Hanno U
AU - Rostock, Thomas
AU - Lutomsky, Boris
AU - Risius, Tim
AU - Steven, Daniel
AU - Weiss, Christian
AU - Meinertz, Thomas
AU - Willems, Stephan
N1 - (c) 2007 S. Karger AG, Basel
PY - 2008
Y1 - 2008
N2 - OBJECTIVE: Catheter ablation of ventricular tachycardia (VT) after myocardial infarction (MI) can be complex and time-consuming. We only targeted the previously documented VTs and those with similar or longer cycle lengths.METHODS: 30 patients with VTs after MI were included in the study. Voltage mapping was performed using an electro-anatomic mapping system (CARTOT). Stable VTs were mapped during tachycardia and unstable VTs during sinus rhythm.RESULTS: Clinical VTs were stable in 16 (53%) and unstable in 14 (47%) patients, and ablation was successful in 11 (69%) and 9 patients (64%), respectively (p = 0.42). During follow-up (14 +/- 6 months), 4 patients (25%) treated for stable and 6 (43%) for unstable VTs had recurrences (p = 0.82); ablation was successful in none and 2 (33%) of them, respectively. Non-target VTs were inducible in 11 (55%) of 20 patients after successful ablation and non-inducible in 9 (45%). During follow-up, inducibility of non-target VTs did not predict recurrences (9 vs. 11%, p = 0.88).CONCLUSIONS: Catheter ablation of VTs after MI can be successfully performed. Acute success rates seem to be similar for stable and unstable VTs. VTs faster than those documented clinically exert a minor effect on VT recurrences during follow-up.
AB - OBJECTIVE: Catheter ablation of ventricular tachycardia (VT) after myocardial infarction (MI) can be complex and time-consuming. We only targeted the previously documented VTs and those with similar or longer cycle lengths.METHODS: 30 patients with VTs after MI were included in the study. Voltage mapping was performed using an electro-anatomic mapping system (CARTOT). Stable VTs were mapped during tachycardia and unstable VTs during sinus rhythm.RESULTS: Clinical VTs were stable in 16 (53%) and unstable in 14 (47%) patients, and ablation was successful in 11 (69%) and 9 patients (64%), respectively (p = 0.42). During follow-up (14 +/- 6 months), 4 patients (25%) treated for stable and 6 (43%) for unstable VTs had recurrences (p = 0.82); ablation was successful in none and 2 (33%) of them, respectively. Non-target VTs were inducible in 11 (55%) of 20 patients after successful ablation and non-inducible in 9 (45%). During follow-up, inducibility of non-target VTs did not predict recurrences (9 vs. 11%, p = 0.88).CONCLUSIONS: Catheter ablation of VTs after MI can be successfully performed. Acute success rates seem to be similar for stable and unstable VTs. VTs faster than those documented clinically exert a minor effect on VT recurrences during follow-up.
KW - Aged
KW - Catheter Ablation/adverse effects
KW - Electrophysiologic Techniques, Cardiac
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Tachycardia, Ventricular/diagnosis
KW - Treatment Outcome
U2 - 10.1159/000105326
DO - 10.1159/000105326
M3 - SCORING: Journal article
C2 - 17627109
VL - 109
SP - 52
EP - 61
JO - CARDIOLOGY
JF - CARDIOLOGY
SN - 0008-6312
IS - 1
ER -