Systematic review and meta-analysis of catheter ablation of ventricular tachycardia in ischemic heart disease

Martinez, Brandon K.; Baker, William L.; Konopka, Anna; Giannelli, Devon; Coleman, Craig I.; Kluger, Jeffrey; Cronin, Edmond M.

doi:10.1016/j.hrthm.2019.04.024

Cited by 40 publications

(27 citation statements)

References 29 publications

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“…Four RCTs have examined the role of catheter ablation in patients who have experienced their first episode of VT ( S4.4.10 – S4.4.14 ). In these studies, an ICD has been a mandatory part of the protocol.…”

Section: Clinical Evaluationmentioning

confidence: 99%

“…The Substrate Modification Study (SMS) failed to meet its primary endpoint of time to first VT/VF recurrence; however, catheter ablation reduced the total number of ICD interventions ( S4.4.13 ). A meta-analysis of these trials, commissioned to guide recommendations in this consensus document, showed a reduction in the risk of appropriate ICD therapies with catheter ablation ( S4.4.14 ). However, in drafting this recommendation, the writing committee also considered that only the CALYPSO pilot study randomized patients to either catheter ablation or AAD therapy ( S4.4.12 ).…”

Section: Clinical Evaluationmentioning

confidence: 99%

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2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

et al. 2020

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Representative of the European Heart Rhythm Association (EHRA) †Representative of the American College of Cardiology (ACC) ‡Representative of the Sociedade Brasileira de Arritmias Cardíacas (SOBRAC) xRepresentative of the American Heart Association (AHA) {Representative of the Latin American Heart Rhythm Society (LAHRS) #Representative of the Asia Pacific Heart Rhythm Society (APHRS) **Representative of the Japanese Heart Rhythm Society (JHRS) † †Representative of the Pediatric and Congenital Electrophysiology Society (PACES)

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Section: Clinical Evaluationmentioning

confidence: 99%

Section: Clinical Evaluationmentioning

confidence: 99%

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

et al. 2020

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“…Unique to this consensus statement is the systematic review commissioned specifically for this document as part of HRS’s efforts to adopt the rigorous methodology required for guideline development. The systematic review was performed by an experienced evidence-based practice committee based at the University of Connecticut, which examined the question of VT ablation vs control in patients with VT and ischemic heart disease (IHD) ( S1.2.3 ). The question, in PICOT format, was as follows: In adults with history of sustained VT and IHD, what is the effectiveness and what are the detriments of catheter ablation compared with other interventions?…”

Section: Introductionmentioning

confidence: 99%

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias: Executive summary

et al. 2020

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Ventricular arrhythmias are an important cause of morbidity and mortality and come in a variety of forms, from single premature ventricular complexes to sustained ventricular tachycardia and fibrillation. Rapid developments have taken place over the past decade in our understanding of these arrhythmias and in our ability to diagnose and treat them. The field of catheter ablation has progressed with the development of new methods and tools, and with the publication of large clinical trials. Therefore, global cardiac electrophysiology professional societies undertook to outline recommendations and best practices for these procedures in a document that will update and replace the 2009 EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias. An expert writing group, after reviewing and discussing the literature, including a systematic review and meta‐analysis published in conjunction with this document, and drawing on their own experience, drafted and voted on recommendations and summarized current knowledge and practice in the field. Each recommendation is presented in knowledge byte format and is accompanied by supportive text and references. Further sections provide a practical synopsis of the various techniques and of the specific ventricular arrhythmia sites and substrates encountered in the electrophysiology lab. The purpose of this document is to help electrophysiologists around the world to appropriately select patients for catheter ablation, to perform procedures in a safe and efficacious manner, and to provide follow‐up and adjunctive care in order to obtain the best possible outcomes for patients with ventricular arrhythmias.

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“…A prespecified subgroup analysis restricting the study sample to only patients with ischemic heart disease (IHD), classified based on the presence of myocardial infarction or coronary artery disease was performed. This was based on data that patients with IHD who underwent VT ablation compared with medical therapy have lower rates of appropriate ICD therapies, VT storm, and cardiac hospitalization …”

Section: Methodsmentioning

confidence: 99%

Real‐world outcomes of ventricular tachycardia catheter ablation with versus without intracardiac echocardiography

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Reynolds

et al. 2019

Cardiovasc electrophysiol

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Introduction: By providing real-time monitoring of catheter-tissue interface and for complications, intracardiac echocardiography (ICE) during catheter ablation for ventricular tachycardia (VT) may improve outcomes. To test this hypothesis, we compared 12-month readmission rates (all-cause, cardiovascular [CV]-related, and VT-related), repeat ablation, and complications among patients with VT with structural heart disease undergoing ablation with versus without ICE. Methods and results: Using the 2008-2017 IBM MarketScan Commercial and Medicare Supplemental databases, patients with a history of implantable cardioverter defibrillator/cardiac resynchronization therapy (ICD/CRT-D) who underwent VT ablation with and without ICE use were identified. Propensity matching was performed and regression analysis was used to compare outcomes. After matching, 1324 patients were identified (ICE: 662; non-ICE: 662). The rate of 12-month VT-related readmission (18.13% vs 22.51%; P < .05) and repeat VT ablation (14.35% vs 19.34%; P = .02) postindex discharge were lower among patients in the ICE group compared with the non-ICE group, with a 24% lower risk of 12-month VT-related readmission (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.58-0.99) and a 30% lower risk of repeat ablation (OR, 0.70; 95% CI, 0.52-0.93) vs non-ICE group. The 12-month all-cause (44.56% vs 43.20%; P = .62) and CV-related readmissions (35.20% vs 32.93%; P = 0.38) and complication rates were not significantly different between the two groups.Conclusions: VT ablation using ICE was associated with a lower likelihood of 12-month VT-related readmission and repeat ablation compared with non-ICE patients. K E Y W O R D Scatheter ablation, claims database, intracardiac echocardiography, ventricular tachycardia

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Systematic review and meta-analysis of catheter ablation of ventricular tachycardia in ischemic heart disease

Cited by 40 publications

References 29 publications

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias

2019 HRS/EHRA/APHRS/LAHRS expert consensus statement on catheter ablation of ventricular arrhythmias: Executive summary

Real‐world outcomes of ventricular tachycardia catheter ablation with versus without intracardiac echocardiography

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