Prediction and prognosis of ventricular tachycardia recurrence after catheter ablation with remote magnetic navigation for electrical storm in patients with ischemic cardiomyopathy

Qi, Jin; Jacobsen, Peter Karl; Pehrson, Steen; Chen, Xu

doi:10.1002/clc.22773

Cited by 5 publications

(2 citation statements)

References 25 publications

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“…Numerous factors have proven reliable in assessing periprocedural risk and anticipating prognosis after VT ablation (however not exclusively in ES) [ 4 , 8 , 10 , 11 , 13 , 14 , 19 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

MSA-VT Score for Assessment of Long-Term Prognosis after Electrical Storm Ablation

Vatasescu,

Cojocaru,

Gondos

et al. 2024

Biomedicines

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Introduction: Prognosis after electrical storm (ES) ablation remains severe, especially in patients with recurrent sustained monomorphic ventricular tachycardia (SMVT) or progressive heart failure (HF). However, single-factor-based prediction is suboptimal and may be refined by more complex algorithms. We sought to evaluate if a novel score MSA-VT (M = moderate/severe mitral regurgitation, S = severe HF at admission, A = atrial fibrillation at admission, VT = inducible SMVT after ablation) may improve prediction of death and recurrences compared to single factors and previous scores (PAINESD, RIVA and I-VT). Methods: A total of 101 consecutive ES ablation patients were retrospectively analyzed over a 32.8-month (IQR 10-68) interval. The MSA-VT score was calculated as the sum of the previously mentioned factors’ coefficients based on hazard ratio values in Cox regression analysis. The AUC for death prediction by MSA-VT was 0.84 (p < 0.001), superior to PAINESD (AUC 0.63, p = 0.03), RIVA (AUC 0.69, p = 0.02) and I-VT (0.56, p = 0.3). MSA-VT ≥ 3 was associated with significantly higher mortality during follow-up (52.7%, p < 0.001). Conclusions: Prediction by single factors and previously published scores after ES ablation may be improved by the novel MSA-VT score; however, this requires further external validation in larger samples.

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Section: Discussionmentioning

confidence: 99%

MSA-VT Score for Assessment of Long-Term Prognosis after Electrical Storm Ablation

Vatasescu,

Cojocaru,

Gondos

et al. 2024

Biomedicines

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“…During a follow-up of 15 months, 60% of patients were free of VA recurrences and 94% were free of electrical storm. Since then ablation of VT has evolved, and new approaches and technologies, such as the substrate approach, 30 remote magnetic navigation, 31 and a combined endo-epicardial substrate ablation, 32 have improved the outcome of VT ablation (Table 2). 33…”

Section: Treatment Of Electrical Storm: Corresponding To the Mechanismentioning

confidence: 99%

Editor’s Choice-The treatment of electrical storm: an educational review

Hendriks

Szili-Török

2018

European Heart Journal: Acute Cardiovascular Care

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Electrical storm is characterised by a state of severe electrical instability that occurs in a rare combination of circumstances, and may lead to multiple implantable cardioverter defibrillator shocks and haemodynamic instability, and possible death. The main goal of treating electrical storm is to eliminate the trigger and modify the substrate of the arrhythmia. The aim of this educational review is to provide information for a better understanding of the underlying mechanisms and therefore help to improve the treatment of electrical storm patients.

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Pre-procedural image-guided versus non-image-guided ventricular tachycardia ablation—a review

et al. 2020

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Background Magnetic resonance imaging and computed tomography in patients with ventricular tachycardia (VT) after myocardial infarction (MI) helps to delineate scar from healthy tissue. Image-guided VT ablation has not yet been studied on a large scale. Objective The aim of the meta-analysis was to compare the long-term outcome of image-guided VT ablation with a conventional approach for VT after MI. Methods Eight electronic bibliographic databases were searched to identify all relevant studies from 2012 until 2018. The search for scientific literature was performed for studies that described the outcome of VT ablation in patients with an ischaemic substrate. The outcome of image-guided ablation was compared with the outcome of conventional ablations. Results Of the 2990 citations reviewed for eligibility, 38 articles—enrolling a total of 7748 patients—were included into the meta-analysis. Five articles included patients with image-guided ablation. VT-free survival was 82% [74–90] in the image-guided VT ablation versus 59% [54–64] in the conventional ablation group (p < 0.001) during a mean follow-up of 35 months. Overall survival was 94% [90–98] in the image-guided versus 82% [76–88] in the conventional VT ablation group (p < 0.001). Conclusions Image-guided VT ablation in ischaemic VT was associated with a significant benefit in VT-free and overall survival as compared with conventional VT ablation. Visualising myocardial scar facilitates substrate-guided ablation procedures, pre-procedurally and by integrating imaging during the procedure, and may consequently improve long-term outcome.

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Prediction and prognosis of ventricular tachycardia recurrence after catheter ablation with remote magnetic navigation for electrical storm in patients with ischemic cardiomyopathy

Abstract: Inducibility of any VT at the end of procedure for VT storm guided by RMN is the strongest predictor of VT recurrence. ICM patients who have early recurrences after VT storm ablation are at high risk of all-cause death.

Cited by 5 publications

References 25 publications

MSA-VT Score for Assessment of Long-Term Prognosis after Electrical Storm Ablation

MSA-VT Score for Assessment of Long-Term Prognosis after Electrical Storm Ablation

Editor’s Choice-The treatment of electrical storm: an educational review

Pre-procedural image-guided versus non-image-guided ventricular tachycardia ablation—a review

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