Predictors of VT recurrence in patients with VT inducibility at the end
of radiofrequency ablation: Should we use VT non-inducibility as a
routine endpoint?
Abstract
Introduction: It has been reported that ventricular tachycardia (VT)
non-inducibility at the end of ablation is associated with less likely
VT recurrence. However, it is not clear whether we should use VT
non-inducibility as routine end point in VT ablation. The aim of this
study was to evaluate VT recurrence in patients in whom VT
non-inducibility could not be achieved at the end of the RF ablation and
the factors attributing to the VT recurrence. METHODS and RESULTS: We
analyzed 84 consecutive patients that underwent RF ablation, and 64
patients in whom VT non-inducibility could not be achieved were studied.
The primary endpoint was recurrence of any sustained VT during the
follow-up. During a median follow-up period of 1.4 years (IQR:0.3-2.0),
22 (34%) of the cases had VT recurrences. In the multivariate analysis
showed that an LVEF≥35% (HR:0.21; 95% CI:0.07- 0.54; P<0.01)
and successful identification and ablation of all clinical VT isthmuses
(HR:0.21; 95% CI:0.03- 0.72; P=0.01) were independent predictors of
fewer VT recurrences. RF ablation was associated with a 91.1% reduction
in VT episodes. CONCLUSION: Even if VT non-inducibility could not be
achieved, the patients with LVEF≥35% or in whom all clinical VT
isthmuses could successfully be identify and ablated might be prevented
from having VT recurrences. The validity of VT non-inducibility of any
VT should be evaluated by each patient’s background and the results of
the procedure.