Results of treatment of patients with recurrent ischemic ventricular tachycardia using radiofrequency ablation method in Perm Krai

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Abstract

Objective. To analyze the results of radiofrequency catheter ablation in patients with stable ventricular tachycardia (VT), which is one of the basic causes of mortality in patients with structural heart disease and the most common mechanism of circulatory arrest.

Materials and methods. The results of radiofrequency catheter ablation were retrospectively analyzed in 10 patients with structural cardiac pathology, who suffered from stable monomorphic ventricular tachycardia, refractory to drug therapy.

Results. The primary final point of the study was freedom from recurrence of monomorphic VT paroxysms.  In our study, freedom from recurrent monomorphic VT paroxysms after the conducted RFA in patients with structural cardiac pathology for an average follow-up period of 14.5 ± 6.3 months was 70 %.

Conclusions. The radiofrequency catheter ablation can be considered as an optimal method for the treatment of recurrent VT paroxysms at the background of noneffective drug therapy in patients with structural changes in the heart caused by old myocardial infarction in anamnesis. 

About the authors

S. N. Azizov

S.G. Sukhanov Federal Center for Cardiovascular Surgery

Author for correspondence.
Email: azizov.s89@mail.ru

Candidate of Medical Sciences, Cardiovascular Surgeon

Russian Federation, Perm

R. D. Khuziakhmetov

S.G. Sukhanov Federal Center for Cardiovascular Surgery

Email: azizov.s89@mail.ru

Cardiovascular Surgeon

Russian Federation, Perm

A. T. Kozhenov

S.G. Sukhanov Federal Center for Cardiovascular Surgery

Email: azizov.s89@mail.ru

Cardiovascular Surgeon

Russian Federation, Perm

R. N. Gordiychuk

S.G. Sukhanov Federal Center for Cardiovascular Surgery

Email: azizov.s89@mail.ru

Cardiovascular Surgeon

Russian Federation, Perm

References

  1. Bojcov S.A., Nikulina N.N., Jakushin S.S., Akinina S.A., Furmenko G.I. Sudden cardiac death in patients with coronary heart disease according to the results of the Russian multicenter epidemiological study of morbidity, mortality, quality of diagnosis and treatment of acute forms of coronary heart disease (RESONANCE). Russian Journal of Cardiology. 2011; (2): 59–64 (in Russian).
  2. Bardy G.H., Lee K.L., Mark D.B. et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005; 352 (3): 225–237.
  3. The Antiarrhythmics versus Implantable Defibrillator (AVID) Investigators. A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias (AVID). N Engl J Med. 1997; 337 (22): 1576–1583.
  4. Buxton A., Lee K., DiCarlo L., Gold M., Greer S., Prystowsky E., et al. Electrophysiologic testing to identify patients with coronary artery disease who are at risk for sudden death. N Engl J Med. 2000; 342 (26): 1937–45.
  5. Moss A.J., Zareba W., Hall W.J., Klein H., Wilber D.J., Cannom D.S. et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002; 346 (12): 877–83.
  6. Poole J.E., Johnson G.W., Hellkamp A.S. et al. Prognostic importance of defibrillator shocks in patients with heart failure. N Engl J Med. 2008; 359 (10): 1009–1017.
  7. Sweeney M.O., Sherfesee L., DeGroot P.J., Wathen M.S., Wilkoff B.L. Differences in effects of electrical therapy type for ventricular arrhythmias on mortality in implantable cardio-verterdefibrillator patients. Heart Rhythm. 2010; 7 (3): 353–360.
  8. Moss A.J., Greenberg H., Case R.B., Zareba W., Hall W.J., Brown M.W. et al. Long-term clinical course of patients after termination of ventricular tachyarrhythmia by an implanted defibrillator. Circulation 2004; 110 (25): 3760–65.
  9. Packer D.L., Prutkin J.M., Hellkamp A.S. et al. Impact of implantable cardioverter-defibrillator, amiodarone, and placebo on the mode of death in stable patients with heart failure: analysis from the sudden cardiac death in heart failure trial. Circula-tion 2009; 120 (22): 2170–2176.
  10. Al-Khatib S.M., Stevenson W.G., Acker-man M.J., Bryant W.J., Callans D.J., Curtis A.B., Deal B.J., Dickfeld T., Field M.E., Fonarow G.C., Gillis A.M., Granger C.B., Hammill S.C., Hlatky M.A., Joglar J.A., Kay G.N., Matlock D.D., Myerburg R.J., Page R.L. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm 2018; 15 (10): e73-e189. doi: 10.1016/j.hrthm.2017.10.036.
  11. Priori S.G., Blomström-Lundqvist C., Mazzanti A., Blom N., Borggrefe M., Camm J., Elliott P.M., Fitzsimons D., Hatala R., Hindricks G., Kirchhof P., Kjeldsen K., Kuck K.H., Hernandez-Madrid A., Nikolaou N., Norekval T.M., Spaulding C., Van Veldhuisen D.J. Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ven-tricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC) Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Europace. 2015; 17 (11): 1601–87. doi: 10.1093/europace/euv319.
  12. Klein L.S., Shih H.T., Hackett F.K., Zipes D.P., & Miles W.M. Radiofrequency catheter ablation of ventricular tachycardia in patients without structural heart disease. Circulation 1992; 85 (5):6 1666–74.
  13. Morady F., Harvey M., Kalbfleisch S.J., el-Atassi R., Calkins H., & Langberg J.J. Radiofrequency catheter ablation of ventricular tachycardia in patients with coronary artery disease. Circulation 1993; 87 (2): 363–72.
  14. Palaniswamy C., Kolte D., Harikrishnan P. et al. Catheter ablation of post infarction ventricular tachycardia: tenyear trends in utilization, in-hospital complications, and in-hospital mortality in the United States. Heart Rhythm 2014; 11 (11): 2056–2063.
  15. Patel D., Hasselblad V., Jackson K.P., Pokorney S.D., Daubert J.P., Al-Khatib S.M. Catheter ablation for ventricular tachycardia (VT) in patients with ischemic heart disease: a systematic review and a meta-analysis of randomized controlled trials. J Interv Card Electrophysiol. 2016; 45 (2): 111–7. doi: 10.1007/s10840-015-0083-4.
  16. Haanschoten D.M., Smit J.J.J., Adiyaman A., Ramdat Misier A.R., Hm Delnoy P.P., Elvan A. Long-term outcome of catheter ablation in post-infarction recurrent ventricular tachycardia. Scand Cardiovasc J. 2019; 53 (2): 62–70. doi: 10.1080/14017431.2019.1601253.
  17. Samuel M., Rivard L., Nault I., Gula L., Essebag V., Parkash R., Sterns L.D., Khairy P., Sapp J.L. Comparative effectiveness of ventricular tachycardia ablation vs. escalated anti-arrhythmic drug therapy by location of myocardial infarction: a substudy of the VANISH trial. Europace. 2022; 24 (6): 948–958. doi: 10.1093/europace/euab298.

Supplementary files

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2. Fig. 1. Multipole navigation catheters used to perform high-density mapping

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3. Fig. 2. Left ventricular endogram performed during mapping with a multipole catheter. The oval indicates late potentials

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4. Fig. 3. Freedom from recurrence of ventricular tachycardia paroxysms in the postoperative period

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