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Impact of a high-density grid catheter on long-term outcomes for structural heart disease ventricular tachycardia ablation
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Proietti, Riccardo, Dowd, Rory, Gee, Lim Ven, Yusuf, Shamil, Panikker, Sandeep, Hayat, Sajad, Osman, Faizel, Patel, Kiran, Salim, Handi, Aldhoon, Bashar, Foster, Will, Merghani, Ahmed, Kuehl, Michael, Banerjee, Prithwish, Lellouche, Nicolas and Dhanjal, Tarvinder (2021) Impact of a high-density grid catheter on long-term outcomes for structural heart disease ventricular tachycardia ablation. Journal of Interventional Cardiac Electrophysiology, 62 . pp. 519-529. doi:10.1007/s10840-020-00918-4
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WRAP-impact-high-density-grid-catheter-long-term-outcomes-structural-heart-disease-ventricular-tachycardia ablation-Dhanjal-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (2833Kb) | Preview |
Official URL: http://dx.doi.org/10.1007/s10840-020-00918-4
Abstract
Substrate mapping has highlighted the importance of targeting diastolic conduction channels and late potentials during ventricular tachycardia (VT) ablation. State-of-the-art multipolar mapping catheters have enhanced mapping capabilities. The purpose of this study was to investigate whether long-term outcomes were improved with the use of a HD Grid mapping catheter combining complementary mapping strategies in patients with structural heart disease VT. Consecutive patients underwent VT ablation assigned to either HD Grid, Pentaray, Duodeca, or point-by-point (PbyP) RF mapping catheters. Clinical endpoints included recurrent anti-tachycardia pacing (ATP), appropriate shock, asymptomatic non-sustained VT, or all-cause death. Seventy-three procedures were performed (33 HD Grid, 22 Pentaray, 12 Duodeca, and 6 PbyP) with no significant difference in baseline characteristics. Substrate mapping was performed in 97% of cases. Activation maps were generated in 82% of HD Grid cases (Pentaray 64%; Duodeca 92%; PbyP 33% (p = 0.025)) with similar trends in entrainment and pace mapping. Elimination of all VTs occurred in 79% of HD Grid cases (Pentaray 55%; Duodeca 83%; PbyP 33% (p = 0.04)). With a mean follow-up of 372 ± 234 days, freedom from recurrent ATP and shock was 97% and 100% respectively in the HD Grid group (Pentaray 64%, 82%; Duodeca 58%, 83%; PbyP 33%, 33% (log rank p = 0.0042, p = 0.0002)). This study highlights a step-wise improvement in survival free from ICD therapies as the density of mapping capability increases. By using a high-density mapping catheter and combining complementary mapping strategies in a strict procedural workflow, long-term clinical outcomes are improved.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RC Internal medicine | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||||
| Library of Congress Subject Headings (LCSH): | Ventricular tachycardia, Catheter ablation, Coronary heart disease | ||||||||
| Journal or Publication Title: | Journal of Interventional Cardiac Electrophysiology | ||||||||
| Publisher: | Springer | ||||||||
| ISSN: | 1572-8595 | ||||||||
| Official Date: | December 2021 | ||||||||
| Dates: |
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| Volume: | 62 | ||||||||
| Page Range: | pp. 519-529 | ||||||||
| DOI: | 10.1007/s10840-020-00918-4 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access |
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