TY - JOUR
T1 - Long-term success of irrigated radiofrequency catheter ablation of sustained ventricular tachycardia
T2 - Post-approval THERMOCOOL VT trial
AU - Marchlinski, Francis E.
AU - Haffajee, Charles I.
AU - Beshai, John F.
AU - Dickfeld, Timm Michael L.
AU - Gonzalez, Mario D.
AU - Hsia, Henry H.
AU - Schuger, Claudio D.
AU - Beckman, Karen J.
AU - Bogun, Frank M.
AU - Pollak, Scott J.
AU - Bhandari, Anil K.
N1 - Publisher Copyright:
© 2016 American College of Cardiology Foundation.
PY - 2016/2/16
Y1 - 2016/2/16
N2 - Background Radiofrequency catheter ablation is used to treat recurrent ventricular tachycardia (VT). Objectives This study evaluated long-term safety and effectiveness of radiofrequency catheter ablation using an open-irrigated catheter. Methods Patients with sustained monomorphic ventricular tachycardia associated with coronary disease were analyzed for cardiovascular-specific adverse events within 7 days of treatment, hospitalization duration, 6-month sustained monomorphic ventricular tachycardia recurrence, quality of life measured by the Hospital Anxiety and Depression Scale, long-term (1-, 2-, and 3-year) survival, symptomatic VT control, and amiodarone use. Results Overall, 249 patients, mean age 67.4 years, were enrolled. The cardiovascular-specific adverse events rate was 3.9% (9 of 233) with no strokes. Noninducibility of targeted VT was achieved in 75.9% of patients. Post-ablation median hospitalization was 2 days. At 6 months, 62.0% (114 of 184) of patients had no sustained monomorphic ventricular tachycardia recurrence; the proportion of patients with implantable cardioverter-defibrillator shocks decreased from 81.2% to 26.8% (p < 0.0001); the frequency of VT in implantable cardioverter-defibrillator patients with recurrences was reduced by ≥50% in 63.8% of patients; and the proportion with normal Hospital Anxiety and Depression Scale scores increased from 48.8% to 69.1% (p < 0.001). Patient-reported VT remained steady for 1, 2, and 3 years at 22.7%, 29.8%, and 24.1%, respectively. Amiodarone use and hospitalization decreased from 55% and 77.2% pre-ablation to 23.3% and 30.7%, 18.5% and 36.7%, 17.7% and 31.3% at 1, 2, and 3 years, respectively. Conclusions Radiofrequency catheter ablation reduced implantable cardioverter-defibrillator shocks and VT episodes and improved quality of life at 6 months. A steady 3-year nonrecurrence rate with reduced amiodarone use and hospitalizations indicate improved long-term outcomes.
AB - Background Radiofrequency catheter ablation is used to treat recurrent ventricular tachycardia (VT). Objectives This study evaluated long-term safety and effectiveness of radiofrequency catheter ablation using an open-irrigated catheter. Methods Patients with sustained monomorphic ventricular tachycardia associated with coronary disease were analyzed for cardiovascular-specific adverse events within 7 days of treatment, hospitalization duration, 6-month sustained monomorphic ventricular tachycardia recurrence, quality of life measured by the Hospital Anxiety and Depression Scale, long-term (1-, 2-, and 3-year) survival, symptomatic VT control, and amiodarone use. Results Overall, 249 patients, mean age 67.4 years, were enrolled. The cardiovascular-specific adverse events rate was 3.9% (9 of 233) with no strokes. Noninducibility of targeted VT was achieved in 75.9% of patients. Post-ablation median hospitalization was 2 days. At 6 months, 62.0% (114 of 184) of patients had no sustained monomorphic ventricular tachycardia recurrence; the proportion of patients with implantable cardioverter-defibrillator shocks decreased from 81.2% to 26.8% (p < 0.0001); the frequency of VT in implantable cardioverter-defibrillator patients with recurrences was reduced by ≥50% in 63.8% of patients; and the proportion with normal Hospital Anxiety and Depression Scale scores increased from 48.8% to 69.1% (p < 0.001). Patient-reported VT remained steady for 1, 2, and 3 years at 22.7%, 29.8%, and 24.1%, respectively. Amiodarone use and hospitalization decreased from 55% and 77.2% pre-ablation to 23.3% and 30.7%, 18.5% and 36.7%, 17.7% and 31.3% at 1, 2, and 3 years, respectively. Conclusions Radiofrequency catheter ablation reduced implantable cardioverter-defibrillator shocks and VT episodes and improved quality of life at 6 months. A steady 3-year nonrecurrence rate with reduced amiodarone use and hospitalizations indicate improved long-term outcomes.
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U2 - 10.1016/j.jacc.2015.11.041
DO - 10.1016/j.jacc.2015.11.041
M3 - Article
C2 - 26868693
AN - SCOPUS:84958811753
SN - 0735-1097
VL - 67
SP - 674
EP - 683
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 6
ER -