Impact of a high-density grid catheter on long-term outcomes for structural heart disease ventricular tachycardia ablation
© 2020. The Author(s)..
BACKGROUND: Substrate mapping has highlighted the importance of targeting diastolic conduction channels and late potentials during ventricular tachycardia (VT) ablation. State-of-the-art multipolar mapping catheters have enhanced mapping capabilities. The purpose of this study was to investigate whether long-term outcomes were improved with the use of a HD Grid mapping catheter combining complementary mapping strategies in patients with structural heart disease VT.
METHODS: Consecutive patients underwent VT ablation assigned to either HD Grid, Pentaray, Duodeca, or point-by-point (PbyP) RF mapping catheters. Clinical endpoints included recurrent anti-tachycardia pacing (ATP), appropriate shock, asymptomatic non-sustained VT, or all-cause death.
RESULTS: Seventy-three procedures were performed (33 HD Grid, 22 Pentaray, 12 Duodeca, and 6 PbyP) with no significant difference in baseline characteristics. Substrate mapping was performed in 97% of cases. Activation maps were generated in 82% of HD Grid cases (Pentaray 64%; Duodeca 92%; PbyP 33% (p = 0.025)) with similar trends in entrainment and pace mapping. Elimination of all VTs occurred in 79% of HD Grid cases (Pentaray 55%; Duodeca 83%; PbyP 33% (p = 0.04)). With a mean follow-up of 372 ± 234 days, freedom from recurrent ATP and shock was 97% and 100% respectively in the HD Grid group (Pentaray 64%, 82%; Duodeca 58%, 83%; PbyP 33%, 33% (log rank p = 0.0042, p = 0.0002)).
CONCLUSIONS: This study highlights a step-wise improvement in survival free from ICD therapies as the density of mapping capability increases. By using a high-density mapping catheter and combining complementary mapping strategies in a strict procedural workflow, long-term clinical outcomes are improved.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:62 |
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| Enthalten in: |
Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing - 62(2021), 3 vom: 03. Dez., Seite 519-529 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Proietti, Riccardo [VerfasserIn] |
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| Links: |
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| Themen: |
Catheter ablation |
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| Anmerkungen: |
Date Completed 07.12.2021 Date Revised 18.02.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s10840-020-00918-4 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM319568512 |
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| 245 | 1 | 0 | |a Impact of a high-density grid catheter on long-term outcomes for structural heart disease ventricular tachycardia ablation |
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| 500 | |a Date Revised 18.02.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020. The Author(s). | ||
| 520 | |a BACKGROUND: Substrate mapping has highlighted the importance of targeting diastolic conduction channels and late potentials during ventricular tachycardia (VT) ablation. State-of-the-art multipolar mapping catheters have enhanced mapping capabilities. The purpose of this study was to investigate whether long-term outcomes were improved with the use of a HD Grid mapping catheter combining complementary mapping strategies in patients with structural heart disease VT | ||
| 520 | |a METHODS: Consecutive patients underwent VT ablation assigned to either HD Grid, Pentaray, Duodeca, or point-by-point (PbyP) RF mapping catheters. Clinical endpoints included recurrent anti-tachycardia pacing (ATP), appropriate shock, asymptomatic non-sustained VT, or all-cause death | ||
| 520 | |a RESULTS: Seventy-three procedures were performed (33 HD Grid, 22 Pentaray, 12 Duodeca, and 6 PbyP) with no significant difference in baseline characteristics. Substrate mapping was performed in 97% of cases. Activation maps were generated in 82% of HD Grid cases (Pentaray 64%; Duodeca 92%; PbyP 33% (p = 0.025)) with similar trends in entrainment and pace mapping. Elimination of all VTs occurred in 79% of HD Grid cases (Pentaray 55%; Duodeca 83%; PbyP 33% (p = 0.04)). With a mean follow-up of 372 ± 234 days, freedom from recurrent ATP and shock was 97% and 100% respectively in the HD Grid group (Pentaray 64%, 82%; Duodeca 58%, 83%; PbyP 33%, 33% (log rank p = 0.0042, p = 0.0002)) | ||
| 520 | |a CONCLUSIONS: This study highlights a step-wise improvement in survival free from ICD therapies as the density of mapping capability increases. By using a high-density mapping catheter and combining complementary mapping strategies in a strict procedural workflow, long-term clinical outcomes are improved | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Catheter ablation | |
| 650 | 4 | |a High density mapping | |
| 650 | 4 | |a Long term outcome | |
| 650 | 4 | |a Ventricular tachycardia | |
| 700 | 1 | |a Dowd, Rory |e verfasserin |4 aut | |
| 700 | 1 | |a Gee, Lim Ven |e verfasserin |4 aut | |
| 700 | 1 | |a Yusuf, Shamil |e verfasserin |4 aut | |
| 700 | 1 | |a Panikker, Sandeep |e verfasserin |4 aut | |
| 700 | 1 | |a Hayat, Sajad |e verfasserin |4 aut | |
| 700 | 1 | |a Osman, Faizel |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Kiran |e verfasserin |4 aut | |
| 700 | 1 | |a Salim, Handi |e verfasserin |4 aut | |
| 700 | 1 | |a Aldhoon, Bashar |e verfasserin |4 aut | |
| 700 | 1 | |a Foster, Will |e verfasserin |4 aut | |
| 700 | 1 | |a Merghani, Ahmed |e verfasserin |4 aut | |
| 700 | 1 | |a Kuehl, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Banerjee, Prithwish |e verfasserin |4 aut | |
| 700 | 1 | |a Lellouche, Nicolas |e verfasserin |4 aut | |
| 700 | 1 | |a Dhanjal, Tarvinder |e verfasserin |4 aut | |
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