Effectiveness and Safety of Intramyocardial Needle Ablation for Refractory Ventricular Tachycardia and Premature Ventricular Complexes: A Systematic Review and Meta‐Analysis.

Introduction: Intramyocardial needle ablation is a novel technique for treating refractory ventricular tachycardia (VT) and premature ventricular complexes (PVC). However, studies defining the effectiveness and safety of this procedure are limited. This meta‐analysis aims to evaluate the safety and...

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Publicado en:Journal of Cardiovascular Electrophysiology Vol. 36; no. 9; pp. 2279 - 2287
Autores principales: Gupta, Kartik, Qureshi, Muhammad Ahmad, Rawlley, Bharat, Jain, Vardhmaan, Verma, Atul, Siontis, Konstantinos C., Deskhmukh, Abhishekh, Khan, Arfaat, Raad, Mohamad
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell Sep2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2025
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      pub: Wiley-Blackwell
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        atl: Effectiveness and Safety of Intramyocardial Needle Ablation for Refractory Ventricular Tachycardia and Premature Ventricular Complexes: A Systematic Review and Meta‐Analysis.
      aug:
        au:
          Gupta, Kartik
          Qureshi, Muhammad Ahmad
          Rawlley, Bharat
          Jain, Vardhmaan
          Verma, Atul
          Siontis, Konstantinos C.
          Deskhmukh, Abhishekh
          Khan, Arfaat
          Raad, Mohamad
        affil: Edith and Benson Ford Heart and Vascular Institute, Division of Cardiovascular Diseases, Henry Ford Hospital, Detroit Michigan,, USA
      sug:
        subj:
          Ablation Techniques
          Catheter Ablation
          Tachycardia, Ventricular Surgery
          Premature Ventricular Contractions Surgery
          Patient Safety Evaluation
          Treatment Outcomes Evaluation
          Ablation Techniques Evaluation
          Action Potentials Evaluation
          Needles Utilization
          Recurrence Risk Factors
          Risk Assessment
          Human
          Male
          Female
          Middle Age
          Aged
          Systematic Review
          Meta Analysis
          Heart Rate
          Time Factors
          Ventricular Ejection Fraction Physiology
          Fluoroscopy
          Embase
          Medline
          Checklists
          Age Factors
          Sex Factors
          Antiarrhythmia Agents Therapeutic Use
          Heart Failure Etiology
          Descriptive Statistics
          Data Analysis Software
          Perioperative Care
          Postoperative Complications
          Pericardial Effusion Risk Factors
          Embolism
          Catheter Ablation Equipment and Supplies
          Shock, Cardiogenic
          Death Risk Factors
          Confidence Intervals
          Catheter Ablation Adverse Effects
          Cardiac Tamponade
          Equipment Failure
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Introduction: Intramyocardial needle ablation is a novel technique for treating refractory ventricular tachycardia (VT) and premature ventricular complexes (PVC). However, studies defining the effectiveness and safety of this procedure are limited. This meta‐analysis aims to evaluate the safety and effectiveness of needle ablation for VT and PVC refractory to standard ablation. Methods: Embase, Ovid (includes Medline), and ClinicalTrials.gov were searched from inception to December 31, 2024. Human studies on needle ablation for recurrent VT and PVC were included. Primary outcome was immediate effectiveness (no immediate post‐procedural inducible VT or PVC). Secondary outcomes were long‐term effectiveness (no clinical VT or PVC at 6 months) and safety (composite measure of peri‐ and post‐procedural complications). Results: A total of five studies including 180 patients (140 VT; 40 PVC) were analyzed. Mean ages ranged from 54 to 66 years. Among 129 patients with VT, immediate effectiveness was 75% (95% CI, 54–92; I2 80%), and cumulative freedom from clinical VT dropped to 43% at 6 months (95% CI, 35–52; I2 0%). Among 40 patients with PVC, immediate effectiveness was 82% (95% CI, 67–94; I2 0%), and long‐term effectiveness was 76% (95% CI, 61–90; I2 0%). Safety outcomes were reported in 19% of patients (95% CI, 13–27; I2 0%) and 10% of patients (95% CI 1, 23; I2 0%) in the VT and PVC arm, respectively. Death related to ablation was report in 7 patients (5.0%) only in the VT studies. Conclusion: Intramyocardial needle ablation is an emerging alternative approach for refractory VT and PVC ablation, showing cautious but promising results and safety profiles. Prospective studies and an international registry could provide valuable insights needed for optimal patient selection and protocol refinement.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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