Noninducibility of VT after VT ablation is associated with improved arrhythmia-free survival and all-cause mortality
BACKGROUND Although ventricular tachycardia ( VT ) ablation is a widely used therapy for patients with VT , the ideal end points for this procedure are not well defined .
We performed a meta- analysis of the published literature to assess the predictive value of noninducibility of postinfa rct ion VT for long-term outcomes after VT ablation .
Elimination of Local Abnormal Ventricular Activities: A New End Point for Substrate Modification in Patients With Scar-Related Ventricular Tachycardia
Background — Catheter ablation of ventricular tachycardia ( VT )  is effective and particularly useful in patients with frequent defibrillator interventions . Various substrate modification techniques have been described for unmappable or hemodynamically intolerable VT . Noninducibility is the most frequently used end point but is associated with significant limitations , so the optimal end point remains unclear . We hypothesized that elimination of local abnormal ventricular activities ( LAVAs ) during sinus rhythm or ventricular pacing would be a useful and effective end point for substrate-based VT ablation . As an adjunct to this strategy , we used a new high-density mapping catheter and frequently used epicardial mapping . Methods and Results — Seventy patients ( age , 67±11 years ; 7 female ) with VT and structurally abnormal ventricle(s ) were prospect ively enrolled .  Conventional mapping was performed in sinus rhythm in all , and a high-density Pentaray mapping catheter was used in the endocardium ( n=35 ) and epicardially . LAVAs were recorded in 67 patients ( 95.7 % ; 95 % confidence interval , 89.2–98.9 ) . Catheter ablation was performed targeting LAVA with an irrigated-tip catheter placed endocardially via a transseptal or retro grade aortic approach or epicardially via the subxiphoid approach . LAVAs were successfully abolished or dissociated in 47 of 67 patients ( 70.1 % ; 95 % confidence interval , 58.7–80.1 ) . In multivariate analysis , LAVA elimination was independently associated with a reduction in recurrent VT or death ( hazard ratio , 0.49 ; 95 % confidence interval , 0.26–0.95 ; P=0.035 ) during long-term follow-up ( median , 22 months ) . Conclusions — LAVAs can be identified in most patients with scar-related VT . Elimination of LAVAs is feasible and safe and is associated with superior survival free from recurrent VT
Noninducibility of VT after VT ablation is associated with improved arrhythmia-free survival and all-cause mortality
BACKGROUND Although ventricular tachycardia ( VT ) ablation is a widely used therapy for patients with VT , the ideal end points for this procedure are not well defined .
We performed a meta- analysis of the published literature to assess the predictive value of noninducibility of postinfa rct ion VT for long-term outcomes after VT ablation .