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Basu-Ray I, Khanra D, Shah SK, Mukherjee A, Char SV, Jain B, Bunch TJ, Gold M, Adeboye AA, Saeed M. Meta-analysis comparing outcomes of catheter ablation for ventricular arrhythmia in ischemic versus nonischemic cardiomyopathy. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2020; 44:54-62. [PMID: 33216394 PMCID: PMC7984079 DOI: 10.1111/pace.14129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 10/20/2020] [Accepted: 11/15/2020] [Indexed: 11/29/2022]
Abstract
Background Catheter ablation is an effective treatment for ventricular arrhythmia (VA) in ischemic cardiomyopathy (ICM). However, results in non‐ICM (NICM) patients are not satisfactory, and studies comparing differences between NICM and ICM are limited. We conducted a meta‐analysis of procedural characteristics and long‐term outcomes of catheter ablation for VA, comparing results between ICM and NICM. Methods Studies in the PubMed, EMBASE, and Cochrane databases were systematically reviewed. Four studies reporting comparison of catheter ablation of VA between ICM and NICM were examined. The Newcastle‐Ottawa Scale was used to appraise study quality. A random‐effects model with inverse variance method was used for comparisons. Results Epicardial approach was significantly more undertaken for the NICM group than in the ICM group (odds ratio [OR]: 0.13; 95% confidence interval [CI]: 0.09‐0.18; P < .00001). Mean ablation time (P = .54), fluoroscopy time (P = .55), and procedural time (P = .18) did not differ significantly between the ICM and NICM groups. Procedural failure rates (OR: 0.46; 95% CI: 0.24‐0.89; P = .02) and VA recurrence rates (risk ratio [RR]: 0.68; 95% CI: 0.46‐1.01; P = .06) were significantly higher in the NICM group than in the ICM group. However, all‐cause mortality (RR: 1.37; 95% CI: 0.75‐2.49; P = .31) did not differ significantly between groups. Conclusions Procedural failure and VA recurrence rates were significantly higher in the NICM group, despite significantly more frequent epicardial access. These highlight the limitations of catheter ablation for VA in NICM, given our current knowledge.
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Affiliation(s)
- Indranill Basu-Ray
- Department of Cardiology, Memphis VA Medical Center, 1030 Jefferson Ave, Memphis, TN, 38104.,School of Public Health, The University of Memphis, Memphis, TN, USA.,Dept of Cardiology, All India Institute of Medical Sciences, Rishikesh, UK, India
| | - Dibbendhu Khanra
- Department of Cardiology, Heart and Lung Centre, New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Sumit K Shah
- Department of Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Sudhanva V Char
- Department of Cardiology, Life University, Marietta, Georgia
| | - Bhavna Jain
- Department of Cardiology, Heart and Lung Centre, New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - T Jared Bunch
- Department of Cardiology, University of Utah Hospital, University of Utah School of Medicine, Salt Lake City, Utah
| | - Michael Gold
- Department of Cardiology, Medical University of South Carolina, Charleston, South Carolina
| | - Adedayo A Adeboye
- Department of Cardiology, Memphis VA Medical Center, 1030 Jefferson Ave, Memphis, TN, 38104
| | - Mohammad Saeed
- Department of Cardiology, Medical University of South Carolina, Charleston, South Carolina.,Department of Cardiology, Baylor College of Medicine, Houston, Texas
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Della Bella P, Frontera A. The importance of electrical mapping of VT in the approaching era of clinical imaging. J Cardiovasc Electrophysiol 2020; 31:2041-2042. [DOI: 10.1111/jce.14620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 10/24/2022]
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Ventricular tachycardia ablation in patients with structural heart disease: single centre experience. MARMARA MEDICAL JOURNAL 2020. [DOI: 10.5472/marumj.681982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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