Influence of clinical and procedural predictors on ventricular tachycardia ablation outcomes: an analysis from the substrate mapping and ablation in sinus rhythm to halt ventricular tachycardia trial (SMASH-VT)
Procedural Predictors in SMASH-VT. Background: The Substrate Mapping and Ablation in Sinus Rhythm to Halt Ventricular Tachycardia (SMASH-VT) trial is the largest randomized trial in substrate-based ablation. We performed a retrospective analysis of patients randomized to prophylactic ablation of ven...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 21; no. 7; pp. 799 - 804 |
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| Autores principales: | , , , |
| Formato: | clinical trial research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105046017&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105046017 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jul2010 vid: 21 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105046017 105046017 2010704861 10.1111/j.1540-8167.2009.01705.x NLM20132389 105046017 ppf: 799 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Influence of clinical and procedural predictors on ventricular tachycardia ablation outcomes: an analysis from the substrate mapping and ablation in sinus rhythm to halt ventricular tachycardia trial (SMASH-VT) aug: au: Tung R Josephson ME Reddy V Reynolds MR affil: UCLA Medical Center, Los Angeles, California sug: subj: Catheter Ablation Defibrillators, Implantable Electrophysiology Tachycardia, Ventricular Treatment Outcomes Aged Chi Square Test Clinical Trials Cox Proportional Hazards Model Female Funding Source Human Kaplan-Meier Estimator Male Medical Records Middle Age Multivariate Analysis Random Assignment Retrospective Design United States Wilcoxon Rank Sum Test Aged: 65+ years Middle Aged: 45-64 years Female Male ab: Procedural Predictors in SMASH-VT. Background: The Substrate Mapping and Ablation in Sinus Rhythm to Halt Ventricular Tachycardia (SMASH-VT) trial is the largest randomized trial in substrate-based ablation. We performed a retrospective analysis of patients randomized to prophylactic ablation of ventricular tachycardia to determine the predictive value of clinical and procedural variables on outcomes. Methods: In patients treated with catheter ablation, we examined predictors of ICD-therapy free survival using Cox proportional hazards models. Procedural variables tested included the scar location, number of VT morphologies (VTs) induced, tachycardia cycle length, catheter irrigation, catheter approach, procedural duration, and VT inducibility after ablation. Clinical variables including age, index arrhythmia, NYHA class, ejection fraction, prior revascularization, and baseline medication use were also analyzed. Results: Among 64 patients randomized to ablation, 61 received the assigned therapy and complete procedural data were available for 54 patients. Thirteen percent (7 of 54) experienced ICD therapies during 2-year follow-up. Patients with subsequent ICD therapies had significantly more VTs induced during the ablation procedure than those without (3.9 ± 2.1 vs 1.9 ± 1.8, P = 0.05). The hazard ratio for each additional VT induced was 1.51 (95% CI 1.07-2.13, P = 0.02). Two-year Kaplan-Meier event-free survival rates were 96% for 0-1 VTs induced, and 78% for two or more. The use of irrigated catheters was not predictive of ablation success. Conclusion: In this small retrospective analysis, the number of VTs induced during the procedure was predictive of 2-year outcomes. This likely reflects a more complex arrhythmia substrate in patients who fail ablation. (J Cardiovasc Electrophysiol, Vol. pp. 799-803, July 2010) pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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