Ventricular Tachycardia Ablation Registry.

Study Overview
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Brief Summary
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Catheter ablation of Ventricular Tachycardias is a well-established approach in clinical practice in patients with Implantable Cardioverter Defibrillator (ICD) implanted. Previous studies have shown a significant reduction in appropriate shocks (  20%) and a significant reduction in hospitalizations for cardiovascular reasons (  12%) in patients with ischemic heart disease treated with ablation. Recent works have also shown the effectiveness of the ablation procedure using as procedural target the reduction of late potentials. However, actually it is necessary to have an homogenize and accepted mapping scheme in Sinus Rhythm to ablate Ventricular Tachycardias related to scar substrate in patients with: Previous MI Previous myocarditis Arrhythmogenic Right Ventricular Dysplasia (ARVD) Idiopathic Dilated Cardiomyopathy (IDCM) Scope of the registry is to collect data during cardiac mapping in Sinus Rhythm in patients indicated for Ventricular Tachycardia ablation, that will be performed per clinical practice, by using the St. Jude Medical EnSiteTM PrecisionTM mapping system. The objective of the present registry is: to assess the acute and long-term efficacy of the strategy of substrate abolition (abolishment of complex and late potentials) guided by electroanatomic mapping with Precision software.

Detailed Description
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This is an Italian multicenter, observational, prospective and retrospective registry. Data will be collected during enrollment/baseline, procedure, pre-discharge and during the follow-up visits according to the standard practice of participating centers, with mandatory visits at 6 and 12 months. Data can also be collected retrospectively, prior informed consent of the patient. The planned enrollment duration is approximately 24 months.

Official Title
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Ventricular Tachycardia Ablation Registry. Italian Registry of Substrate Mapping and VT Ablation With the Precision Mapping System and Flexability Catheter.

Conditions
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Ventricular Tachycardia

Intervention / Treatment
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* Device: Catheter ablation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with an implanted ICD Patients with indication to Ventricular Tachycardia Ablation procedure, supported by EnSite Precision 3D mapping system (previous MI, myocarditis, ARVD, IDCM) Age 18 years or more Able to provide an informed consent to participate to the registry and available to respect the assessments described in the protocol Exclusion Criteria: Contraindication to anticoagulants Presence of thrombi Presence of Mitral and Aortic prosthetic valve Recent (<3 months) myocardial infarction or unstable angina or Coronary Artery Bypass Pregnant or nursing Ventricular Tachycardia caused by reversible pathology < 1 Year life expectancy according to the investigator Contraindication to the use of ablation/diagnostic catheters or to cardiac catheterism

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Catheter ablation|Ventricular Tachycardia ablation, that will be performed per clinical practice, by using EnSite Precision mapping system with the Flexability catheter (St.Jude, now Abbott)|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Late potential abolition and ventricular tachycardia noninducibility | Combined procedural endpoint of late potential (LP) abolition and VT noninducibility (endpoint expected in 50% of cases). LP abolition assessed as % of persistent LP area at remap after ablation, compared to the basal activation map. | Intraprocedural | 
| Ventricular tachycardia recurrence | Freedom from Ventricular Tachycardia episodes requiring ICD Intervention (shock or Anti-Tachycardia Pacing) | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complications | Periprocedural complications | During hospitalization: starting during the procedure until discharge | 
| Complications | Long term catheter ablation complications | 12 months | 
| Procedural parameters | Procedure duration measured in minutes | Intraprocedural | 
| Procedural parameters | Fluoroscopy exposure measured in Gycm2 | Intraprocedural | 
| Assessment of cardiac mapping system EnSite Precision™ software (St.Jude, now Abbott) | Geometry precision, descriptive | Intraprocedural | 
| Assessment of cardiac mapping system EnSite Precision™ software (St.Jude, now Abbott) | Mapping accuracy, descriptive | Intraprocedural | 
| Assessment of cardiac mapping system EnSite Precision™ software (St.Jude, now Abbott) | System overall stability, descriptive | Intraprocedural | 
| Assessment of cardiac mapping system EnSite Precision™ software (St.Jude, now Abbott) | Non-recoverable shifts/drifts, descriptive | Intraprocedural |