RT Journal Article
T1 Safety, long-term outcomes and predictors of recurrence after first-line combined endoepicardial ventricular tachycardia substrate ablation in arrhythmogenic cardiomyopathy. Impact of arrhythmic substrate distribution pattern. A prospective multicentre study.
A1 Berruezo, Antonio
A1 Acosta, Juan
A1 Fernández-Armenta, Juan
A1 Pedrote, Alonso
A1 Barrera, Alberto
A1 Arana-Rueda, Eduardo
A1 Bodegas, Andrés Ignacio
A1 Anguera, Ignasi
A1 Tercedor, Luis
A1 Penela, Diego
A1 Andreu, David
A1 Perea, Rosario Jesus
A1 Prat-González, Susana
A1 Mont, Lluis
K1 Arrhythmogenic cardiomyopathy
K1 Epicardial ablation
K1 Long-term outcomes
K1 Scar dechanneling
K1 Ventricular tachycardia
AB First-line endoepicardial ventricular tachycardia (VT) ablation has been proposed for patients with arrhythmogenic cardiomyopathy (AC). This study reports procedural safety, outcomes, and predictors of recurrence. Forty-one consecutive patients [12 with left ventricle (LV) involvement, 7 left-dominant] underwent first-line endoepicardial VT substrate ablation. Standard bipolar and unipolar thresholds were used to define low-voltage areas (LVA). Arrhythmogenic substrate area (ASA) was defined as the area containing electrograms with delayed components. Implantable cardioverter defibrillator interrogations were evaluated for VT recurrence. Epicardial LVA was larger in all cases (102.5 ± 78.6 vs. 19.3 ± 24.4 cm2; P0.23 predicted an epi-ASA ≤10 cm2 (100% sensitivity, 84% specificity). Patients showing an epi-ASA  First-line endoepicardial VT substrate ablation achieves good long-term results in AC. Left-dominant AC is associated with an increased risk of recurrence. The Bi/Uni-LVA ratio identifies patients with limited epicardial arrhythmogenic substrate in whom the indication of epicardial approach should be more cautiously assessed.
YR 2017
FD 2017
LK http://hdl.handle.net/10668/11124
UL http://hdl.handle.net/10668/11124
LA en
DS RISalud
RD Apr 11, 2025