Ventricular Tachycardia
Conditions
Brief summary
Catheter ablation of Ventricular Tachycardias is a well-established approach in clinical practice in patients with Implantable Cardioverter Defibrillator (ICD) implanted. Previous studies have shown a significant reduction in appropriate shocks (\ 20%) and a significant reduction in hospitalizations for cardiovascular reasons (\ 12%) in patients with ischemic heart disease treated with ablation. Recent works have also shown the effectiveness of the ablation procedure using as procedural target the reduction of late potentials. However, actually it is necessary to have an homogenize and accepted mapping scheme in Sinus Rhythm to ablate Ventricular Tachycardias related to scar substrate in patients with: * Previous MI * Previous myocarditis * Arrhythmogenic Right Ventricular Dysplasia (ARVD) * Idiopathic Dilated Cardiomyopathy (IDCM) Scope of the registry is to collect data during cardiac mapping in Sinus Rhythm in patients indicated for Ventricular Tachycardia ablation, that will be performed per clinical practice, by using the St. Jude Medical EnSiteTM PrecisionTM mapping system. The objective of the present registry is: to assess the acute and long-term efficacy of the strategy of substrate abolition (abolishment of complex and late potentials) guided by electroanatomic mapping with Precision software.
Detailed description
This is an Italian multicenter, observational, prospective and retrospective registry. Data will be collected during enrollment/baseline, procedure, pre-discharge and during the follow-up visits according to the standard practice of participating centers, with mandatory visits at 6 and 12 months. Data can also be collected retrospectively, prior informed consent of the patient. The planned enrollment duration is approximately 24 months.
Interventions
DEVICECatheter ablation
Ventricular Tachycardia ablation, that will be performed per clinical practice, by using EnSite Precision mapping system with the Flexability catheter (St.Jude, now Abbott)
Sponsors
Paolo Della Bella
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with an implanted ICD * Patients with indication to Ventricular Tachycardia Ablation procedure, supported by EnSite Precision 3D mapping system (previous MI, myocarditis, ARVD, IDCM) * Age 18 years or more * Able to provide an informed consent to participate to the registry and available to respect the assessments described in the protocol
Exclusion criteria
* Contraindication to anticoagulants * Presence of thrombi * Presence of Mitral and Aortic prosthetic valve * Recent (\<3 months) myocardial infarction or unstable angina or Coronary Artery Bypass * Pregnant or nursing * Ventricular Tachycardia caused by reversible pathology * \< 1 Year life expectancy according to the investigator * Contraindication to the use of ablation/diagnostic catheters or to cardiac catheterism
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Late potential abolition and ventricular tachycardia noninducibility | Intraprocedural | Combined procedural endpoint of late potential (LP) abolition and VT noninducibility (endpoint expected in 50% of cases). LP abolition assessed as % of persistent LP area at remap after ablation, compared to the basal activation map. |
| Ventricular tachycardia recurrence | 12 months | Freedom from Ventricular Tachycardia episodes requiring ICD Intervention (shock or Anti-Tachycardia Pacing) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complications | During hospitalization: starting during the procedure until discharge | Periprocedural complications |
| Procedural parameters | Intraprocedural | Procedure duration measured in minutes |
| Assessment of cardiac mapping system EnSite Precision™ software (St.Jude, now Abbott) | Intraprocedural | Geometry precision, descriptive |
Countries
Italy
Outcome results
None listed