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 postinfarction VT for long-term outcomes after VT ablation. Methods and Results-We performed a systematic review of MEDLINE (1950MEDLINE ( -2013, EMBASE (1988EMBASE ( -2013, the Cochrane Controlled Trials Register (Fourth Quarter, 2012), and reports presented at scientific meetings (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013). Randomized controlled trials, case-control, and cohort studies of VT ablation were included. Outcomes reported in eligible studies were freedom from VT/ventricular fibrillation and all-cause mortality. Of the 3895 studies evaluated, we identified 8 cohort studies enrolling 928 patients for the meta-analysis. Noninducibility after VT ablation was associated with a significant increase in arrhythmia-free survival compared with partial success (odds ratio, 0.49; 95% confidence interval, 0.29-0.84; P=0.009) or failed ablation procedure (odds ratio, 0.10; 95% confidence interval, 0.06-0.18; P<0.001). There was also a significant reduction in all-cause mortality if patients were noninducible after VT ablation compared with patients with partial success (odds ratio, 0.59; 95% confidence interval, 0.36-0.98; P=0.04) or failed ablation (odds ratio, 0.32; 95% confidence interval, 0.10-0.99; P=0.049). Web-based search engine OVID with explode option for each subject term and the option AND for combining keywords. The MEDLINE was searched from January 1950 to May 2013. The MeSH terms included VT and ablation. We also used a previously developed MEDLINE search strategy to retrieve the strongest scientific studies of treatment by conducting a sensitive search. 11 The EMBASE database was searched from January 1988 to 2013 with keywords including VT and catheter ablation. The Cochrane Controlled Trials Register was searched with a similar approach. All searches were performed in May 2013. We conducted additional searches using 11 author names frequently cited in narrative reviews of VT ablation, as well as modified versions of the Cochrane Optimal Search Strategy. 12 The bibliographies of 10 most recent narrative review articles were also hand-searched. To reduce bias, we restricted our searches to articles reported in English language. 13 Because the meta-analysis was an analysis of prior published studies, an institutional review board approval is not applicable. Conclusions-Noninducibility Study SelectionRandomized controlled trials, case-control, or cohort studies evaluating ablation for treatment of VT were eligible. Case-control and cohort studies were defined according to the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) statement. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses...

Noninducibility after VT ablation in patients with post-infarction VT is independently associated with lower mortality during long-term follow-up.

The results indicated that high TH17/Treg ratio exists inrheumatic MVD. This imbalance may play a role in the pathogenesis, and TH17/Treg balance may be a promising therapeutic approach in RHD.

Paucity of PVCs at the beginning of an ablation procedure is associated with a lower ablation success rate independent of the site of origin.

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This study was sought to examine the effects of repetitive monomorphic premature ventricular contractions (PVCs) on left ventricular (LV) diastolic function. Thirty-three symptomatic patients (Study group, 10 males, mean age 40 +/- 8 years) with normal LV systolic function and repetitive PVCs originating from the right ventricular outflow tract (RVOT-PVCs) on 24-h Holter monitoring, and 30 healthy controls (Control group, 9 males, mean age 37 +/- 9 years) were enrolled in the study. None of the patients had structural heart disease. Diastolic function was assessed by echocardiographic mitral inflow pattern and tissue Doppler imaging. The study group displayed a lower E/A ratio, longer isovolumetric relaxation time (IVRT), and longer E-wave deceleration time (EDT). In the study group 13 patients showed impaired relaxation. While mean values of the systolic velocity (Sa), early diastolic velocity (Ea), and early/late diastolic velocity (Ea/Aa) ratio were significantly lower in the study group, the Aa velocity and E/Ea ratio were significantly higher. Ea velocity was <10 cm/s in 7 study patients. Mitral inflow pattern and Ea velocity was normal in all controls. Significant correlations were found between ventricular premature beats percentage and early to late transmitral flow velocity ratio, EDT, IVRT, Ea velocity, the Ea/Aa ratio, and the E/Ea ratio. In multivariate analysis, total PVC count and age were found to be independent predictors of impaired relaxation. These results suggest that repetitive monomorphic RVOT-PVCs lead to abnormalities of LV diastolic function that may contribute to clinical symptoms in patients with structurally normal hearts.

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The presence or absence of the predominant PVC within 12 hours postablation best correlated with the 3-month-efficacy data. Recurrence of the predominant PVC shortly after ablation did not indicate a procedural failure and the necessity for a repeat procedure. The majority of these patients had a significant, clinically meaningful reduction in their PVC burden. Acute predictors for procedural outcome at 3 months have a high positive but rather low negative predictive value.