Stepwise ablation strategy in radiofrequency ablation improves acute and long-term outcomes of scar-related ventricular tachycardias.

IF 1.4 4区医学 Q4 ENGINEERING, BIOMEDICAL

Technology and Health Care Pub Date : 2025-01-31 DOI:10.1177/09287329241307799

Pin Wang, Yanan Zuo, Chenglong Miao, Lu Xu, Yanwei Wang, Suyun Liu, Ru Xing, Bingyan Guo

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引用次数: 0

Abstract

Background: The optimal intervention procedures for scar-related ventricular tachycardia (VT) is still unclear.

Objective: This study aimed to compare the acute and long-term outcomes of a stepwise ablation approach targeting critical sites identified through activation mapping during VT or pace mapping followed by substrate ablation with substrate modification alone in patients with scar-related VT.

Methods: Data of 41 patients with scar-related VTs treated with stepwise ablation (Group 1, n = 29) or substrate modification alone during sinus rhythm (Group 2, n = 12) were retrospectively reviewed. The procedure acute success and long-term success during follow-up were compared.

Results: There was no statistical difference between the two groups on basic characteristics. Group 1 demonstrated shorter ablation time (P = 0.02), longer VT-free survival rates at a median follow-up of 24.0 months (P = 0.02) and a lower VT recurrence rate (hazard ratio: 0.17, 95% confidence interval: [0.03, 0.93], P = 0.04) compared to Group 2. The acute success and ratio of ablation area to scar area were comparable between the two groups (P ≥ 0.05).

Conclusion: The stepwise ablation strategy shows promise for improving acute and long-term outcomes and reducing the recurrence risk in patients with scar-related VT.

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射频消融中的逐步消融策略可改善疤痕相关室性心动过速的急性和长期预后。

背景：瘢痕相关性室性心动过速（VT）的最佳干预程序尚不清楚。目的：本研究旨在比较疤痕相关室性心动过速（VT）患者的急性和长期预后，通过在室性心动过速期间的激活测绘或起搏测绘确定的关键部位，然后单独进行底物消融和底物修饰。方法：回顾性分析41例在窦性心动过速期间接受分阶段消融（组1，n = 29）或底物修饰（组2，n = 12）治疗的疤痕相关室性心动过速患者的数据。随访期间比较手术的急性成功和长期成功。结果：两组患者基本特征比较，差异无统计学意义。与2组相比，1组消融时间更短（P = 0.02），随访24.0个月时无VT生存率更长（P = 0.02）， VT复发率更低（风险比：0.17,95%可信区间：[0.03,0.93],P = 0.04）。两组急性成功率及消融面积与瘢痕面积之比比较，差异无统计学意义（P≥0.05）。结论：渐进式消融策略有望改善疤痕相关性室速患者的急性和长期预后，并降低复发风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Technology and Health Care HEALTH CARE SCIENCES & SERVICES-ENGINEERING, BIOMEDICAL

CiteScore

2.10

自引率

6.20%

发文量

282

审稿时长

>12 weeks

期刊介绍： Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured. The main focus of THC is related to the overlapping areas of engineering and medicine. The following types of contributions are considered: 1.Original articles: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine. In particular, the clinical benefit deriving from the application of engineering methods and devices in clinical medicine should be demonstrated. Typically, full length original contributions have a length of 4000 words, thereby taking duly into account figures and tables. 2.Technical Notes and Short Communications: Technical Notes relate to novel technical developments with relevance for clinical medicine. In Short Communications, clinical applications are shortly described. 3.Both Technical Notes and Short Communications typically have a length of 1500 words. Reviews and Tutorials (upon invitation only): Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented. The Editorial Board is responsible for the selection of topics. 4.Minisymposia (upon invitation only): Under the leadership of a Special Editor, controversial or important issues relating to health care are highlighted and discussed by various authors. 5.Letters to the Editors: Discussions or short statements (not indexed).