Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease

Bibliographic Details
Main Author: Ferreira, Afonso Nunes
Publication Date: 2024
Other Authors: Brito, Joana, Cortez-Dias, Nuno, Lima da Silva, Gustavo, Pinto, Fausto J., De Sousa, João
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10400.5/98076
Summary: © 2024 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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spelling Preprocedural imaging guiding ventricular tachycardia ablation in structural heart diseaseVT ablationCardiac magnetic resonanceIschemic cardiomyopathyMultidetector computed tomographyNonischemic cardiomyopathy© 2024 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Background: Integration of preprocedural imaging techniques in ventricular tachycardia (VT) ablation may improve the identification of arrhythmogenic substrates, particularly relevant for patients with nonischemic cardiomyopathy (NICM) with sub-optimal outcomes. We assessed the impact of advanced preprocedural imaging on the safety and long-term efficacy of radiofrequency catheter ablation (RCA) for VT, comparing patients with NICM and ischemic cardiomyopathy (ICM). Methods: In this prospective, single-center study, consecutive patients referred for scar-related VT ablation underwent multidetector computed tomography (MDCT) and late gadolinium enhancement cardiac magnetic resonance (LGE-CMR). Images were segmented with ADAS 3D software and integrated into mapping systems. Substrate map collection targeted the imaging-predicted area of interest and the ablation aimed at eliminating all local abnormal ventricular activities. Procedural safety was evaluated with 30-day mortality. Long-term efficacy was assessed by survival free from appropriate ICD shocks at 36 months. Results: 102 patients were included (67 ± 11 years, 94% male; 75 ICM, 27 NICM). All patients underwent MDCT and 35% also underwent LGE-CMR. Procedural safety (4% 30-day mortality, p = .95) and 36-month efficacy were similar in both groups (88.0% vs. 74.1%, HR 2.09; p = .13 in ICM and NICM). Efficacy was higher in patients when VT activation mapping with VT isthmus ablation complemented substrate ablation compared to substrate-based ablation alone (94.5% vs. 80.6%, HR 4.00; p < .05). Conclusion: A preprocedural imaging protocol integrated into the invasive mapping system may improve safety and long-term efficacy, with NICM patients exhibiting outcomes comparable to those with ICM. Activation mapping of the VT on top of substrate ablation may improve prognosis.This study was partially funded by Associação Lusíadas Knowledge CenterWileyRepositório da Universidade de LisboaFerreira, Afonso NunesBrito, JoanaCortez-Dias, NunoLima da Silva, GustavoPinto, Fausto J.De Sousa, João2025-02-04T12:20:49Z20242024-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.5/98076engJ Arrhythm. 2024 Dec 19;41(1):e132051880-427610.1002/joa3.132051883-2148info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-03-17T16:32:59Zoai:repositorio.ulisboa.pt:10400.5/98076Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-29T04:19:25.787296Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease
title Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease
spellingShingle Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease
Ferreira, Afonso Nunes
VT ablation
Cardiac magnetic resonance
Ischemic cardiomyopathy
Multidetector computed tomography
Nonischemic cardiomyopathy
title_short Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease
title_full Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease
title_fullStr Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease
title_full_unstemmed Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease
title_sort Preprocedural imaging guiding ventricular tachycardia ablation in structural heart disease
author Ferreira, Afonso Nunes
author_facet Ferreira, Afonso Nunes
Brito, Joana
Cortez-Dias, Nuno
Lima da Silva, Gustavo
Pinto, Fausto J.
De Sousa, João
author_role author
author2 Brito, Joana
Cortez-Dias, Nuno
Lima da Silva, Gustavo
Pinto, Fausto J.
De Sousa, João
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Ferreira, Afonso Nunes
Brito, Joana
Cortez-Dias, Nuno
Lima da Silva, Gustavo
Pinto, Fausto J.
De Sousa, João
dc.subject.por.fl_str_mv VT ablation
Cardiac magnetic resonance
Ischemic cardiomyopathy
Multidetector computed tomography
Nonischemic cardiomyopathy
topic VT ablation
Cardiac magnetic resonance
Ischemic cardiomyopathy
Multidetector computed tomography
Nonischemic cardiomyopathy
description © 2024 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024-01-01T00:00:00Z
2025-02-04T12:20:49Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.5/98076
url http://hdl.handle.net/10400.5/98076
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv J Arrhythm. 2024 Dec 19;41(1):e13205
1880-4276
10.1002/joa3.13205
1883-2148
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
_version_ 1833602016781271040

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