Safety and Clinical Outcome of Catheter Ablation of Ventricular Arrhythmias Using Contact Force Sensing: Consecutive Case Series

Hendriks, Astrid; Akca, Ferdi; Abkenari, Lara Dabiri; Khan, Muchtiar; Bhagwandien, Rohit; Yap, Sing‐Chien; Wijchers, Sip; Szili-Török, Tamás

doi:10.1111/jce.12762

Cited by 42 publications

(28 citation statements)

References 23 publications

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“…On the other hand, although randomized trials of PVC suppression have not been performed, multiple studies indicate the high efficacy of PVC ablation [ 1 ]. In addition, technological advancements, such as magnetic navigation, have increased the safety of these procedures significantly [ 23 ]. Abolishment of frequent PVCs has been shown to reverse LV dysfunction in PVC-induced cardiomyopathy and improve QoL in patients with structurally normal heart [ 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Coupling interval variability of premature ventricular contractions in patients with different underlying pathology: an insight into the arrhythmia mechanism

Vries

Martirosyan

Domburg

et al. 2018

J Interv Card Electrophysiol

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PurposeCoupling interval (CI) variability of premature ventricular contractions (PVCs) is influenced by the underlying arrhythmia mechanism. The aim of this study was to compare CI variability of PVCs in different myocardial disease entities, in order to gain insight into their arrhythmia mechanism.MethodsSixty-four patients with four underlying pathologies were included: idiopathic (n = 16), non-ischemic dilated cardiomyopathy (NIDCM) (n = 16), familial cardiomyopathy (PLN/LMNA) (n = 16), and post-MI (n = 16)-associated PVCs. The post-MI group was included as a reference, on account of its known re-entry mechanism. On Holter registrations, the first 20 CIs of the dominant PVC morphology were measured manually after which median ΔCI and mean SD of CI/√R-R (= CI of PVC corrected for underlying heart rate) were obtained. Two observers independently measured PVC CIs on pre-selected Holter registrations in order to determine inter- and intra-observer reliability.ResultsThe largest ΔCI was seen in the PLN/LMNA group (220 ms (120–295)), the lowest in the idiopathic group (120 ms (100–190)). The ΔCI in the PLN/LMNA group was significantly larger than the post-MI group (220 ms (120–295) vs 130 ms (105–155), p = 0.023). Mean SD of CI/√R-R in the PLN/LMNA group was also significantly higher than in the post-MI group (p = 0.044). Inter- and intra-observer reliability was good (ICC = 0.91 vs 0.86 and 0.96 vs 0.77, respectively).ConclusionsLow ΔCI and SD of CI/√R-R of idiopathic and NIDCM PVCs suggest that the underlying arrhythmia mechanisms might be re-entry or triggered activity. Abnormal automaticity or modulated parasystole are unlikely mechanisms. High CI variability in PLN/LMNA patients suggests that the re-entry and triggered activity are less likely mechanisms in this group.Electronic supplementary materialThe online version of this article (10.1007/s10840-017-0309-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Coupling interval variability of premature ventricular contractions in patients with different underlying pathology: an insight into the arrhythmia mechanism

Vries

Martirosyan

Domburg

et al. 2018

J Interv Card Electrophysiol

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Section: Discussionmentioning

confidence: 99%

“…Published research includes studies suggesting the effectiveness of RMN in the treatment of challenging arrhythmias including ventricular tachycardia as well as AF. [12][13][14][15] Of particular interest is a recent study by Hendricks et al 14 in which RMN resulted in improved immediate and long-term outcomes as well as reduction in major adverse events in comparison with both traditional manual and contact-force-sensing manual catheters for patients with ventricular tachycardia. We believe that this study broadens this comparison of technologies in current use to a real world population of patients treated for AF.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Remote Magnetic Irrigated Tip Ablation versus Manual Catheter Irrigated Tip Catheter Ablation With and Without Force Sensing Feedback

Weiss

May

Bair

et al. 2016

Cardiovasc electrophysiol

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and contact force (CF) sensing technologies have been utilized in an effort to improve safety and efficacy of catheter ablation. A comparative analysis of the relative short-and long-term outcomes of AF patients has not been performed. As such, we comparatively evaluated the safety and efficacy of these technologies.Methods: A total of 627 patients who underwent catheter ablation with either a manual irrigated tip catheter: (312, 49.8%) or by RMN: (315, 50.2%) were included in this single-center cohort study. Patients treated with CF (59) were analyzed separately as well. One-and 3-year endpoints included death, HF hospitalization, stroke, TIA, and atrial flutter or AF recurrence.Results: Age averaged 65.1 ± 10.7 years and 64.1% male. One-and 3-year endpoints of death, HF hospitalization, stroke, TIA, and atrial flutter or AF recurrence were statistically similar between manual and RMN treated groups. Fluoroscopy times were significantly lower in the RMN group compared to the manual ablation group (8.47 ± 0.45 vs. 9.63 ± 4.06 minutes, P < 0.0001). CF guided patients had 1-year recurrence rate of AF/atrial flutter statistically identical to patients treated with RMN (36.8% vs. 38.6%; P = 1.00).Conclusion: RMN results in outcomes similar to manual navigation. The addition of CF sensing catheters did not improve relative procedural outcome or safety profile in comparison to RMN guided ablation in this large observational study

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“…10 RMN-based ablation has also proved to be safe for VT ablation in the clinical setting. 11 The ease of safe ventricular mapping with the RMN system 12 may lead to better utilization of catheter ablation of structural VT, and has the potential to standardize and increase availability of complex VT ablation procedures beyond expert centers. However, prospective trials are lacking.…”

Section: Introductionmentioning

confidence: 99%

Catheter Ablation of Ischemic Ventricular Tachycardia With Remote Magnetic Navigation: STOP‐VT Multicenter Trial

Škoda

Arya

García

et al. 2016

Cardiovasc electrophysiol

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Safety and Clinical Outcome of Catheter Ablation of Ventricular Arrhythmias Using Contact Force Sensing: Consecutive Case Series

Abstract: The use of CF sensing catheters did not improve procedural outcome or safety profile in comparison to non-CF sensing ablation in this observational study of ventricular arrhythmia ablations.

Cited by 42 publications

References 23 publications

Coupling interval variability of premature ventricular contractions in patients with different underlying pathology: an insight into the arrhythmia mechanism

Coupling interval variability of premature ventricular contractions in patients with different underlying pathology: an insight into the arrhythmia mechanism

A Comparison of Remote Magnetic Irrigated Tip Ablation versus Manual Catheter Irrigated Tip Catheter Ablation With and Without Force Sensing Feedback

Catheter Ablation of Ischemic Ventricular Tachycardia With Remote Magnetic Navigation: STOP‐VT Multicenter Trial

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