Please use this identifier to cite or link to this item: https://doi.org/10.1161/JAHA.113.000072
Title: Acute failure of catheter ablation for ventricular tachycardia due to structural heart disease: Causes and significance
Authors: Tokuda, M
Kojodjojo, P 
Tung, S
Tedrow, U.B
Nof, E
Inada, K
Koplan, B.A
Michaud, G.F
John, R.M
Epstein, L.M
Stevenson, W.G
Keywords: adult
anatomical concepts
article
cardiovascular mortality
catheter ablation
clinical decision making
coronary artery
disease association
epicardium
female
follow up
hazard ratio
heart disease
heart ventricle septum
heart ventricle tachycardia
His bundle
human
independent variable
long term care
major clinical study
male
phrenic nerve
priority journal
recurrent disease
risk assessment
risk factor
structural heart disease
treatment failure
treatment outcome
vascular access
failure
heart disease
heart ventricle tachycardia
middle aged
outcome
structural heart disease
treatment failure
complication
heart disease
Tachycardia, Ventricular
catheter ablation
failure
outcome
structural heart disease
ventricular tachycardia
Catheter Ablation
Female
Heart Diseases
Humans
Male
Middle Aged
Recurrence
Risk Factors
Tachycardia, Ventricular
Treatment Failure
Treatment Outcome
Catheter Ablation
Female
Heart Diseases
Humans
Male
Middle Aged
Recurrence
Risk Factors
Tachycardia, Ventricular
Treatment Failure
Treatment Outcome
Issue Date: 2013
Citation: Tokuda, M, Kojodjojo, P, Tung, S, Tedrow, U.B, Nof, E, Inada, K, Koplan, B.A, Michaud, G.F, John, R.M, Epstein, L.M, Stevenson, W.G (2013). Acute failure of catheter ablation for ventricular tachycardia due to structural heart disease: Causes and significance. Journal of the American Heart Association 2 (3) : e000072. ScholarBank@NUS Repository. https://doi.org/10.1161/JAHA.113.000072
Rights: Attribution 4.0 International
Abstract: Background-Acute end points of catheter ablation for ventricular tachycardia (VT) remain incompletely defined. The aim of this study is to identify causes for failure in patients with structural heart disease and to assess the relation of this acute outcome to longer-term management and outcomes. Methods and Results-From 2002 to 2010, 518 consecutive patients (84% male, 62±14 years) with structural heart disease underwent a first ablation procedure for sustained VT at our institution. Acute ablation failure was defined as persistent inducibility of a clinical VT. Acute ablation failure was seen in 52 (10%) patients. Causes for failure were: intramural free wall VT in 13 (25%), deep septal VT in 9 (17%), decision not to ablate due to proximity to the bundle of His, left phrenic nerve, or a coronary artery in 3 (6%), and endocardial ablation failure with inability or decision not to attempt to access the epicardium in 27 (52%) patients. In multivariable analysis, ablation failure was an independent predictor of mortality (hazard ratio 2.010, 95% CI 1.147 to 3.239, P=0.004) and VT recurrence (hazard ratio 2.385, 95% CI 1.642 to 3.466, P<0.001). Conclusions-With endocardial or epicardial ablation, or both, acute ablation failure was seen in 10% of patients, largely due to anatomic factors. Persistence of a clinical VT is associated with recurrence and comparatively higher mortality. © 2013 The Authors.
Source Title: Journal of the American Heart Association
URI: https://scholarbank.nus.edu.sg/handle/10635/182048
ISSN: 20479980
DOI: 10.1161/JAHA.113.000072
Rights: Attribution 4.0 International
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