Efficacy of Intensive Radiofrequency Energy Delivery to the Localized Dense Scar Area in Post-Infarction Ventricular Tachycardia Ablation ― A Comparative Study With Standard Strategy Targeting the Infarcted Border Zone ―

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<p><b><i>Background:</i></b>Several reports have demonstrated the importance of severely low voltage areas as arrhythmogenic substrates of ventricular tachycardia (VT). However, a comparative study of dense scar-targeted and infarcted border zone-targeted strategies has not been reported.</p><p><b><i>Methods and Results:</i></b>We divided 109 consecutive patients with VT post-infarction from 6 centers into 2 groups according to the ablation strategy used: dense scar-targeted ablation (DS ablation, 48%) or border zone-targeted ablation (BZ ablation, 52%). During DS ablation, we attempted to identify VT isthmuses in the dense scar areas (≤0.6 mV) using detailed pace mapping, and linear ablation lesions were applied mainly to those areas. During BZ ablation, linear ablation of standard low voltage areas (0.5–1.5 mV) was performed along with good pace map sites of the clinical VT. Acute success was defined as complete success (no VTs inducible) or partial success (clinical VT was noninducible). The acute complete success rate was significantly higher for DS ablation than for BZ ablation (62% vs. 42%, P=0.043). During a median follow-up of 37 months, the VT-free survival rate was significantly higher for DS ablation than for BZ ablation (80% vs. 58% at 48 months; log-rank P=0.038).</p><p><b><i>Conclusions:</i></b>DS ablation may be a more effective therapy for post-infarction VT than BZ ablation in terms of the acute complete success rate and long-term follow-up.</p>

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  • 日本循環器學誌

    日本循環器學誌 81(11), 1603-1610, 2017

    一般社団法人 日本循環器学会

各種コード

  • NII論文ID(NAID)
    130006179874
  • NII書誌ID(NCID)
    AA11591968
  • 本文言語コード
    ENG
  • ISSN
    1346-9843
  • NDL 記事登録ID
    028596385
  • NDL 請求記号
    Z54-B860
  • データ提供元
    NDL  J-STAGE 
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