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. 2022 Dec 31;3(4):179-187.
doi: 10.47487/apcyccv.v3i2.236. eCollection 2022 Oct-Dec.

Acute and long-term success of ventricular tachycardia ablation in patients with ischemic heart disease in a Mexican center

[Article in Spanish]
Angel Cueva-Parra  1 , Diego Neach-De La Vega  1 , Paola Yañez-Guerrero  1 , Gabriela Bustillos-García  1 , Jorge Gómez-Flores  1 , Moisés Levinstein  1 , José L Morales  1 , Pedro Iturralde-Torres  1 , Manlio F Márquez  1 , Santiago Nava  1
Affiliations

Acute and long-term success of ventricular tachycardia ablation in patients with ischemic heart disease in a Mexican center

[Article in Spanish]
Angel Cueva-Parra et al. Arch Peru Cardiol Cir Cardiovasc. .

Abstract
in English, Spanish

Objective: . To report the results of ventricular tachycardia (VT) catheter ablation in ischemic heart disease (IHD), and to identify risk factors associated with recurrence in a Mexican center.

Materials and methods: . We made a retrospective review of the cases of VT ablation performed in our center from 2015 to 2022. We analyzed the characteristics of the patients and those of the procedures separately and we determined factors associated with recurrence.

Results: . Fifty procedures were performed in 38 patients (84% male; mean age 58.1 years). Acute success rate was 82%, with a 28% of recurrences. Female sex (OR 3.33, IC 95% 1.66-6.68, p=0.006), atrial fibrillation (OR 3.5, IC 95% 2.08-5.9, p=0.012), electrical storm (OR 2.4, IC 95% 1.06-5.41, p=0.045), functional class greater than II (OR 2.86, IC 95% 1.34-6.10, p=0.018) were risk factors for recurrence and the presence of clinical VT at the time of ablation (OR 0.29, IC 95% 0.12-0.70, p=0.004) and the use of more than 2 techniques for mapping (OR 0.64, IC 95% 0.48-0.86, p=0.013) were protective factors.

Conclusions: . Ablation of ventricular tachycardia in ischemic heart disease has had good results in our center. The recurrence is similar to that reported by other authors and there are some factors associated with it.

Objetivo.: Informar los resultados de la ablación con catéter de taquicardia ventricular (TV) en la cardiopatía isquémica (CI) e identificar los factores de riesgo asociados a la recurrencia en un centro mexicano.

Materiales y métodos: . Se realizó una revisión retrospectiva de los casos de ablación de TV ejecutados en nuestro centro desde 2015 hasta 2022. Se analizó por separado las características de los pacientes y las de los procedimientos y se determinaron los factores asociados a la recidiva.

Resultados: . Se realizaron 50 procedimientos en 38 pacientes (84% varones; edad media 58,1 años). La tasa de éxito agudo fue del 82%, con un 28% de recurrencia. Sexo femenino (OR 3,33, IC 95% 1,66-6,68, p=0,006); fibrilación auricular (OR 3,5, IC 95% 2,08-5,9, p=0,012); tormenta eléctrica (OR 2.4, IC 95% 1.06-5.41, p =0,045); la clase funcional mayor que II (OR 2,86, IC 95% 1,34-6,10, p=0,018) fueron factores de riesgo para recurrencia y la presencia de TV clínica en el momento de la ablación (OR 0,29, IC 95% 0,12- 0,70, p=0,004) y el uso de más de dos técnicas de mapeo (OR 0,64, IC 95% 0,48 - 0,86, p=0,013) fueron factores protectores.

Conclusiones.: La ablación de taquicardia ventricular en cardiopatía isquémica ha tenido buenos resultados en nuestro centro. La tasa de recurrencia es similar a lo reportado por otros autores y existen algunos factores asociados a ella.

Keywords: Catheter Ablation; Ischemic Heart Disease; Ventricular Tachycardia.

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Conflict of interest statement

Conflict of interests: The authors declare no conflict of interest

Figures

Figure 1
Figure 1. A. Voltage map showing a dense scar on the posterior wall of the left ventricle (yellow arrow), fragmented potentials were found in this area (white arrow). Ablation was performed with the substrate modulation technique. This study corresponds to a 49-year-old male patient with dilated ischemic cardiomyopathy. B. Clinical VT of the patient, the QRS is negative in V1 with superior axis, its origin was from the lower basal wall of the left ventricle.
Figure 2
Figure 2. A. Clinical VT of a 62-year-old male with arterial hypertension and diabetes mellitus and multiarterial coronary artery disease. B. Pre-ablation position, the ablation catheter is positioned at the critical point of the tachycardia, where diastolic potentials are observed. The artifact of radiofrequency starts is also observed. C. TV stop after 2.9 seconds of RF start. D. Voltage map on an unconventional scale, where the critical isthmus of TV is identified, right in the middle of the isthmus is the ablation point that managed to end TV.
See this image and copyright information in PMC

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