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Catheter Ablation of Ventricular Tachycardia in Non-ischemic Heart Disease.
MedLine Citation:
PMID:  22942218     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -Catheter ablation of ventricular tachycardia (VT) in non-ischemic heart diseases can be challenging and outcomes across different diseases are incompletely defined. The aim of this study is to describe the outcomes following catheter ablation for non-ischemic VT in a large cohort and compare the electrophysiological findings and outcomes according to the type of underlying disease. METHODS AND RESULTS: -Of 891 consecutive patients undergoing catheter ablation for ventricular arrhythmias, 226 patients (52±14 yrs, 79% male) with sustained VT due to non-ischemic heart disease were included. The primary endpoint was all-cause death or heart transplantation. Secondary endpoints were a composite of death, heart transplantation or readmission due to VT recurrence within 1 year of discharge. Underlying heart diseases were dilated cardiomyopathy(DCM) in 119(53%), valvular heart disease in 34(15%), arrhythmogenic right ventricular cardiomyopathy(ARVC) in 37(16%), congenital heart disease in 16(7%), cardiac sarcoidosis in 13(6%) and hypertrophic cardiomyopathy in 7(3%). After ablation inability to induce any VT was achieved in 55% and another 20% had inducible VTs modified. Major complications occurred in 5%. ARVC had better outcomes than DCM for primary(P=0.002) and secondary endpoint(P=0.004). Sarcoidosis had worse outcome than DCM for secondary endpoint (P=0.002). At 1 year after the last ablation (a mean of 1.4±0.6 procedures, 1 to 4), freedom from death, heart transplantation, and readmission for VT recurrence was achieved in 173(77%) patients. CONCLUSIONS: -In patients with recurrent VT due to nonischemic heart disease, catheter ablation is often useful, although the outcome varies according to the nature of the underlying heart disease.
Authors:
Michifumi Tokuda; Usha B Tedrow; Pipin Kojodjojo; Keiichi Inada; Bruce A Koplan; Gregory F Michaud; Roy M John; Laurence M Epstein; William G Stevenson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-31
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-9-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Brigham and Women's Hospital & Harvard Medical School, Boston, MA.
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