Substrate-Based Ablation Versus Ablation Guided by Activation and Entrainment Mapping for Ventricular Tachycardia: A Systematic Review and Meta-Analysis.
Substrate vs. Activation/Entrainment Guided VT Ablation Introduction Substrate-based ablation for scar-related ventricular tachycardia (VT) has gained prominence: however, there is limited data comparing it to ablation guided predominantly by activation and entrainment mapping of inducible and hemod...
| Published in: | Journal of Cardiovascular Electrophysiology Vol. 27; no. 12; pp. 1437 - 1448 |
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| Main Authors: | , , , , , , |
| Format: | research systematic review tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Dec2016
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=120039568&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 120039568 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Dec2016 vid: 27 iid: 12 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 120039568 120039568 120039568 10.1111/jce.13088 120039568 ppf: 1437 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Substrate-Based Ablation Versus Ablation Guided by Activation and Entrainment Mapping for Ventricular Tachycardia: A Systematic Review and Meta-Analysis. aug: au: KUMAR, SAURABH BALDINGER, SAMUEL H. ROMERO, JORGE FUJII, AKIRA MAHIDA, SAAGAR N. TEDROW, USHA B. STEVENSON, WILLIAM G. affil: Cardiovascular Division, Brigham and Women's Hospital, Boston Massachusetts, USA sug: subj: Tachycardia Ventricular Dysfunction Ablation Techniques Human Time Factors Systematic Review Meta Analysis PubMed Embase Cochrane Library Databases Descriptive Statistics ab: Substrate vs. Activation/Entrainment Guided VT Ablation Introduction Substrate-based ablation for scar-related ventricular tachycardia (VT) has gained prominence: however, there is limited data comparing it to ablation guided predominantly by activation and entrainment mapping of inducible and hemodynamically tolerated VTs. We compared the acute procedural efficacy and outcomes of predominantly substrate-based ablation versus ablation guided predominantly by activation and entrainment mapping. Methods and Results Database searches through April 2016 identified 6 eligible studies (enrolling 403 patients, with 1 randomized study) comparing the 2 strategies. The relative risk of VT recurrence at follow-up was assessed as the primary outcome using a random-effects meta-analysis. Secondary endpoints of acute success (based on noninducibility of VT), procedural complications, and mortality were assessed using weighted mean difference with the random effects model. At a median follow-up of 18 months, the relative risk (RR) of VT recurrence was not significantly different with substrate-based versus activation/entrainment guided VT ablation (0.72, 95% confidence interval [CI] 0.44-1.18), P = 0.2). Acute success (RR 1.02, 95% CI 0.95-1.1, P = 0.6), procedural complications (RR 0.8, 95% CI 0.35-1.82, P = 0.5) cardiovascular mortality and total mortality did not differ significantly (RR 0.83, 95% CI 0.38-1.79, P = 0.6 and RR 0.76, 95% CI 0.36-1.59, P = 0.5, respectively). Conclusions This meta-analysis demonstrates similar acute procedural efficacy, and complications, VT recurrence and mortality rates when comparing a predominantly substrate-based ablation strategy to a strategy guided predominantly by activation and entrainment mapping of inducible and hemodynamically tolerated VTs. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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