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 .
Catheter Ablation for the Treatment of Electrical Storm in Patients With Implantable Cardioverter-Defibrillators: Short- and Long-Term Outcomes in a Prospective Single-Center Study
Background — Electrical storm ( ES ) caused by recurrent episodes of ventricular tachycardia ( VT ) can cause sudden death in patients with implantable cardioverter-defibrillators and adversely affects prognosis in survivors . Catheter ablation has been proposed for treating ES , but its long-term effect in a large population has never been verified . Methods and Results — Ninety-five consecutive patients with coronary artery disease ( 72 patients ) , idiopathic dilated cardiomyopathy ( 10 patients ) , and arrhythmogenic right ventricular dysplasia/cardiomyopathy ( 13 patients ) undergoing catheter ablation for drug-refractory ES  were prospect ively evaluated . Short-term efficacy was defined by a complete protocol of programmed electric stimulation and by in-hospital outcome ; long-term analysis addressed ES recurrence , cardiac mortality , and VT recurrence . Pleomorphic/nontolerated VTs required electroanatomic and noncontact mapping in 48 and 22 patients , respectively , and percutaneous cardiopulmonary support in 10 patients . An epicardial approach was used in 10 patients . After 1 to 3 procedures , induction of any clinical VT(s ) by programmed electrical stimulation was prevented in 85 patients ( 89 % ) . ES was acutely suppressed in all patients ; a minimum period of 7 days with stable rhythm was required before hospital discharge . At a median follow-up of 22 months ( range , 1 to 43 months ) , 87 patients ( 92 % ) were free of ES and 63 patients ( 66 % ) were free of VT recurrence . Eight of 10 patients with persistent inducibility of clinical VT(s ) had ES recurrence ; 4 of them died suddenly despite appropriate implantable cardioverter-defibrillator intervention . All together , 11 of 95 patients ( 12 % ) died of cardiac-related reasons . In the group of patients presenting with all clinical VTs acutely abolished , no ES recurrence was documented , and cardiac mortality was significantly lower compared with the group of patients showing ≥1 clinical VT still inducible after catheter ablation . Conclusions — Advanced strategies of catheter ablation applied to a large population of patients are effective in the short-term treatment of ES . By preventing ES recurrence , catheter ablation may play a protective role over the long term and , together with long-term pharmacological therapy , may favorably affect cardiac mortality
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 .