Vol. 27 No. 2 (2023): In focus: CardioOncology
HEART RHYTHM DISORDERS

High-power radiofrequency ablation for ventricular tachycardia in patients with structural heart disease: one-year follow-up data from the multicenter prospective registry

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  • S.V. Korolev,
  • E.A. Artyukhina,
  • V.V. Shabanov,
  • O.V. Sapelnikov,
  • A.V. Tsyganov,
  • A.Sh. Revishvili,
  • A.B. Romanov
S.V. Korolev
Federal Scientific and Clinical Center of the Federal Medical and Biological Agency, Moscow
Bio
E.A. Artyukhina
A.V. Vishnevsky National Medical Research Center of Surgery, Moscow
V.V. Shabanov
Meshalkin National Medical Research Center, Novosibirsk
O.V. Sapelnikov
E.I. Chazov National Medical Research Center of Cardiology, Moscow
A.V. Tsyganov
Sechenov University, Moscow
A.Sh. Revishvili
A.V. Vishnevsky National Medical Research Center of Surgery, Moscow
A.B. Romanov
Meshalkin National Medical Research Center, Novosibirsk
Ratio of mean ablation index and return of ventricular tachycardia
DOI: https://doi.org/10.21688/1681-3472-2023-2-66-73

Published 2023-06-30

Keywords

  • Defibrillators, Implantable,
  • Follow-Up Studies,
  • Radiofrequency Ablation,
  • Tachycardia, Ventricular,
  • Ventricular Function, Left

How to Cite

Korolev, S., Artyukhina, E., Shabanov, V., Sapelnikov, O., Tsyganov, A., Revishvili, A., & Romanov, A. (2023). High-power radiofrequency ablation for ventricular tachycardia in patients with structural heart disease: one-year follow-up data from the multicenter prospective registry. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 27(2), 66–73. https://doi.org/10.21688/1681-3472-2023-2-66-73

Copyright (c) 2023 Korolev S.V., Artyukhina E.A., Shabanov V.V., Sapelnikov O.V., Tsyganov A.V., Revishvili A.Sh., Romanov A.B.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Background: The outcomes of ventricular tachycardia (VT) ablation in patients with structural heart disease (SHD) are not ideal. High-power radiofrequency ablation (RFA) may have a long-term beneficial effect in this patient cohort.
Objective: To evaluate the safety, early and long-term efficacy of high-power RFA for VT and concomitant SHD in a multicenter prospective registry.
Methods: Our study included a total of 63 patients (66,7% of them were men; median age was 61.0 [51.0-66.5] years) with ischemic heart disease and drug-resistant VT who were scheduled for RFA (50 W). Non-fluoroscopic 3D mapping systems were used for bipolar and activation mapping with standard settings. The safety end point included perioperative complications, such as death, hemopericardium, stroke, myocardial infarction, electrical storm, and vascular complications. The efficacy end points included VT non-inducibility at the end of ablation and freedom from VT at 12 months of the follow-up. The secondary end points were changes in implantable cardioverter-defibrillator (ICD) therapy, sonographic findings, and number of hospital admissions.
Results: All patients underwent VT ablation under general sedation. One clinical VT was induced in 96.8% of the patients before ablation. After ablation no clinical VTs were induced (P < .0001 vs baseline). No perioperative complications were observed. Freedom from VT without antiarrhythmic drugs was 82.6% at 12 months of the follow-up. The number of ICD therapies significantly decreased at 12 months of the follow-up compared with baseline (3.2% vs 31.7%, respectively; P = .0001). The left ventricular ejection fraction increased from 48.7% ± 14.7% at baseline to 50.3% ± 11.9% at 12 months of the follow-up (P = .038). There was a statistically significant decrease in hospital admission rate before and after ablation (from 2 [range: 0-12] to 0 [range: 0-3], P < .0001).
Conclusion: High-power RFA for VT in patients with ischemia demonstrated its safety and high perioperative and long-term efficacy, which were linked to clinical improvement. Further randomized studies will help introduce this VT ablation approach into routine clinical practice.

Received 5 September 2022. Revised 16 February 2023. Accepted 31 May 2023.

Funding: The study did not have sponsorship.

Conflict of interest: The authors declare no conflict of interest.

Contribution of the authors
Conception and study design: S.V. Korolev, A.Sh. Revishvili, A.B. Romanov
Data collection and analysis: S.V. Korolev, E.A. Artyukhina, V.V. Shabanov, O.V. Sapelnikov, A.V. Tsyganov, A.Sh. Revishvili, A.B. Romanov
Statistical analysis: S.V. Korolev
Drafting the article: S.V. Korolev
Critical revision of the article: A.B. Romanov, A.Sh. Revishvili
Final approval of the version to be published: S.V. Korolev, E.A. Artyukhina, V.V. Shabanov, O.V. Sapelnikov, A.V. Tsyganov, A.Sh. Revishvili, A.B. Romanov

pdf (Русский)

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