Ventricular tachycardia ablation in structural heart disease : long term results
Main Author: | |
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Publication Date: | 2022 |
Format: | Master thesis |
Language: | eng |
Source: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Download full: | http://hdl.handle.net/10451/57220 |
Summary: | Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022 |
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oai:recipp.ipp.pt:10400.22/22998 |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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7160 |
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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:RCAAP2023-05-31T01:47:38Zoai:recipp.ipp.pt:10400.22/22998Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:56:38.295933Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
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) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131640923947008 |