Ventricular tachycardia ablation in structural heart disease : long term results

Detalhes bibliográficos
Autor(a) principal: Gomes, João Pedro Freitas Sousa Ramos
Data de Publicação: 2022
Tipo de documento: Dissertação
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10451/57220
Resumo: Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
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spelling Ventricular tachycardia ablation in structural heart disease : long term resultsTaquicardia ventricularAblaçãoDoença cardíaca estruturalCardiologiaTrabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022Introduction: Ventricular tachycardia (VT) occur in the setting of structural heart disease, adversely affecting patients’ prognosis and quality of life. Current therapies such as an implantable cardioverter defibrillator or anti-arrhythmic drugs are sub-optimial in reducing VT recurrence. Despite advances in mapping technology, radiofrequency catheter ablation (RCA) presents sub-optimal outcomes with 5-year recurrence rates above 50%. Objectives: The main objectives of this study were to compare the safety and efficacy of RCA in patients submitted to VT ablation in the context of ICM and NICM. Methods: Single-centre retrospective study of consecutive patients submitted to VT ablation of substrate-guided and activation-guided VT using multipolar catheters (PentaRay™, Orion™, or HDGrid™) and 3D mapping systems (Carto™, Rhythmia™, or Ensite Precision™). Maps in structural heart disease were evaluated in order to identify intra-cicatricial channels (areas of bipolar voltage <1.5mV) in which sequential propagation of local abnormal ventricular activities (LAVAs) were observed, during or after QRS. The ablation strategy aimed at the abolition of all intra-cicatricial LAVAs, directing the radiofrequency applications primarily to the entrances of the channels. Safety was evaluated by 30-day mortality rate after VT ablation. Efficacy was evaluated by freedom from all-cause mortality, appropriate ICD shocks or CV hospitalization at 36 months. Results: 102 patients were enrolled, 75 ICM and 27 NICM patients (94.1% male, 66.7±10.8 years of age, mean follow-up 31.2±21.2 months). There was a similar safety profile between ICM and NICM (4% vs. 3.7%, P = 0.95) and a similar efficacy at 36 months (58.7% vs 33.3%, p=0.12). Appropriate ICD shocks at 36 months were significantly reduced in patients in whom activation-mapping complemented substrate ablation vs substrate-based ablation alone (5.7% vs 21.2%, p<0.05. Conclusion: There was a similar safety and efficacy profile between ICM and NICM patients referred for VT ablation. These results emphasize the importance of VT ablation in non-ischemic patients with structural heart disease and recurrent ventricular tachycardia.Faculdade de Medicina De LisboaRepositório Científico do Instituto Politécnico do PortoGomes, João Pedro Freitas Sousa Ramos2023-05-29T13:59:30Z2022-072022-07-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfhttp://hdl.handle.net/10451/57220engmetadata only accessinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-05-31T01:47:38ZPortal AgregadorONG
dc.title.none.fl_str_mv Ventricular tachycardia ablation in structural heart disease : long term results
title Ventricular tachycardia ablation in structural heart disease : long term results
spellingShingle Ventricular tachycardia ablation in structural heart disease : long term results
Gomes, João Pedro Freitas Sousa Ramos
Taquicardia ventricular
Ablação
Doença cardíaca estrutural
Cardiologia
title_short Ventricular tachycardia ablation in structural heart disease : long term results
title_full Ventricular tachycardia ablation in structural heart disease : long term results
title_fullStr Ventricular tachycardia ablation in structural heart disease : long term results
title_full_unstemmed Ventricular tachycardia ablation in structural heart disease : long term results
title_sort Ventricular tachycardia ablation in structural heart disease : long term results
author Gomes, João Pedro Freitas Sousa Ramos
author_facet Gomes, João Pedro Freitas Sousa Ramos
author_role author
dc.contributor.none.fl_str_mv Repositório Científico do Instituto Politécnico do Porto
dc.contributor.author.fl_str_mv Gomes, João Pedro Freitas Sousa Ramos
dc.subject.por.fl_str_mv Taquicardia ventricular
Ablação
Doença cardíaca estrutural
Cardiologia
topic Taquicardia ventricular
Ablação
Doença cardíaca estrutural
Cardiologia
description Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
publishDate 2022
dc.date.none.fl_str_mv 2022-07
2022-07-01T00:00:00Z
2023-05-29T13:59:30Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/57220
url http://hdl.handle.net/10451/57220
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv metadata only access
info:eu-repo/semantics/openAccess
rights_invalid_str_mv metadata only access
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Faculdade de Medicina De Lisboa
publisher.none.fl_str_mv Faculdade de Medicina De Lisboa
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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repository.mail.fl_str_mv
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