Abstract
BackgroundMagnetic resonance imaging and computed tomography in patients with ventricular tachycardia (VT) after myocardial infarction (MI) helps to delineate scar from healthy tissue. Image-guided VT ablation has not yet been studied on a large scale.ObjectiveThe aim of the meta-analysis was to compare the long-term outcome of image-guided VT ablation with a conventional approach for VT after MI.MethodsEight electronic bibliographic databases were searched to identify all relevant studies from 2012 until 2018. The search for scientific literature was performed for studies that described the outcome of VT ablation in patients with an ischaemic substrate. The outcome of image-guided ablation was compared with the outcome of conventional ablations.ResultsOf the 2990 citations reviewed for eligibility, 38 articles—enrolling a total of 7748 patients—were included into the meta-analysis. Five articles included patients with image-guided ablation. VT-free survival was 82% [74–90] in the image-guided VT ablation versus 59% [54–64] in the conventional ablation group (p < 0.001) during a mean follow-up of 35 months. Overall survival was 94% [90–98] in the image-guided versus 82% [76–88] in the conventional VT ablation group (p < 0.001).ConclusionsImage-guided VT ablation in ischaemic VT was associated with a significant benefit in VT-free and overall survival as compared with conventional VT ablation. Visualising myocardial scar facilitates substrate-guided ablation procedures, pre-procedurally and by integrating imaging during the procedure, and may consequently improve long-term outcome.Electronic supplementary materialThe online version of this article (10.1007/s12471-020-01485-z) contains supplementary material, which is available to authorized users.
Highlights
Magnetic resonance imaging (MRI) and computed tomography advancing ventricular tachycardia (VT) ablation have an important role in diagnosing struc
After full-text reading, 25 articles were further excluded based on extraction of ischaemic VT data and the follow-up criteria
Pre-procedural image-guided versus non-image-guided ventricular tachycardia ablation—a review for VT ablation procedures
Summary
The use of imaging guidance in ventricular tachycardia (VT) ablation for patients with ischaemic heart disease is associated with higher VT-free survival. This is the first study that demonstrates a true large-scale benefit of visualising myocardial scar and integrating imaging in a VT ablation procedure. Channels that correlate with critical VT isthmuses can be identified by searching the scar for abnormal potentials. High-resolution MRI has been demonstrated to be able to delineate areas of surviving myocardial tissue within the scar that correlate with VT channels [3]. Magnetic resonance imaging and computed tomography in patients with ventricular tachycardia (VT) after myocardial infarction (MI) helps to delineate scar from healthy tissue. Image-guided VT ablation has not yet been studied on a large scale
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
