Utility of Ischemia Testing Prior to Ablation for Sustained Monomorphic Ventricular Tachycardia.
Catheter ablation
coronary artery disease
ischemia testing
revascularization
ventricular tachycardia
Journal
The Journal of innovations in cardiac rhythm management
ISSN: 2156-3977
Titre abrégé: J Innov Card Rhythm Manag
Pays: United States
ID NLM: 101589872
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
30
06
2021
accepted:
22
09
2021
entrez:
23
3
2022
pubmed:
24
3
2022
medline:
24
3
2022
Statut:
epublish
Résumé
The aim of this study was to determine the relationship between ischemia testing prior to ablation for sustained monomorphic ventricular tachycardia (VT) (SMVT) and post-ablation mortality and VT recurrence. As SMVT is generally caused by myocardial scar and not active ischemia, the utility of ischemia testing prior to SMVT ablation is unclear. Patients who underwent ablation for SMVT at 2 tertiary care centers between January 2016 and July 2018 were included in a retrospective study. A Kaplan-Meier survival analysis was performed, stratifying patients by pre-ablation ischemia testing for the endpoints of mortality and VT recurrence. A Cox multivariable regression analysis was performed to identify predictors of post-ablation VT recurrence. A total of 163 patients were included, with 46 (28%) patients undergoing ischemia testing prior to ablation. Only 5 of the 46 patients (11%) received revascularization pre-ablation. After a median follow-up period of 625 days (interquartile range, 292-982 days) following ablation, 97 of 163 patients (60%) had VT recurrence, and 32 patients (20%) had died. There was no difference in mortality or VT recurrence between patients who did or did not experience ischemia testing or revascularization. In the multivariable regression analysis, predictors of VT recurrence were the number of anti-arrhythmics failed, non-ischemic cardiomyopathy, sex, and cardiac magnetic resonance imaging pre-ablation. Neither ischemia testing nor revascularization was a significant predictor of VT recurrence in univariable or multivariable regression analysis. In conclusion, ischemia testing is frequently ordered prior to SMVT ablation but infrequently leads to revascularization and is not associated with post-ablation outcomes. The findings support adopting an individualized approach rather than performing routine ischemia testing.
Identifiants
pubmed: 35317206
doi: 10.19102/icrm.2022.130301
pii: icrm.2022.130301
pmc: PMC8930013
doi:
Types de publication
Journal Article
Langues
eng
Pagination
4908-4914Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL159945
Pays : United States
Informations de copyright
Copyright: © 2022 Innovations in Cardiac Rhythm Management.
Déclaration de conflit d'intérêts
Dr. Schumann was supported by a T32 training grant. The other authors report no conflicts of interest for the published content.
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