Abstract 15975: A Meta-analysis of Substrate Modification versus Clinical Ventricular Tachycardia Ablation in Structural Heart Disease
Background: Catheter ablation (CA) is an effective treatment strategy for ventricular tachycardia (VT) in structural heart disease. However, the most effective ablation strategy remains unknown. We performed a meta-analysis comparing procedural characteristics and VT recurrence between substrate modification (SM) and clinical VT ablation (CA)
Methods: We performed a comprehensive literature search through May 30, 2016 comparing SM versus CA for VT in ischemic cardiomyopathy in Pubmed, Ebsco and google scholar databases. A total of 3 eligible studies [2 randomized controlled trials (RCT), 1 prospective observational] consisting of 213 patients (SM group - 107 patients and CM group- 106 patients) were included in the meta-analysis. Follow-up duration for the studies ranged from 12 months to 48 months.
Results: There was no difference in baseline characteristics including age, left ventricular ejection fraction, diabetes, coronary disease, previous implantable cardioverter defibrillator or use of antiarrhythmic drugs between both groups. There was also no difference in number of VT map points obtained, clinical VT cycle length or VT recurrence between both groups on follow up (29% vs. 44%, HR 0.65, 95% CI (0.17-2.4, p=0.5)] (Figure 1). There was no significant difference in fluoroscopy time (p=0.5) and radiofrequency time (p=0.4) between both groups (Figure 2A,B). However, SM group had significantly lower total procedure time when compared with CA (p=0.002) (Figure 3).
Conclusion: SM significantly decreased procedure time with no significant difference in VT recurrence when compared with CA.
Author Disclosures: M. Turagam: None. S. Iskandar: None. M. Lavu: None. D. Atkins: None. S. Bommana: None. D. Lakkireddy: None. M. Reddy: None.
- © 2016 by American Heart Association, Inc.