Heart rhythm · 2026
Lattice-tip catheter for septal ventricular tachycardia ablation guided by preprocedural imaging.
СтатьяНазвание и аннотация: Перевод в очереди
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Verhaeghe Laurens, Ditac Geoffroy, Johner Nicolas, Tétreault-Langlois Marianne, Sdiri-Cheniti Soumaya, Plant Allan, Fitzgerald John, Notaristefano Francesco, Kneizeh Kinan, Monaco Cinzia, Benali Karim, Vlachos Konstantinos, Yokoyama Masaaki, Sacristan Benjamin, Charton Jan, Bouyer Benjamin, Arnaud Marine, Derval Nicolas, Pambrun Thomas, Hocini Mélèze, Jaïs Pierre, Haïssaguerre Michel, Duchateau Josselin, Tixier Romain, Cochet Hubert, Sacher Frédéric
Аннотация
BACKGROUND: Outcomes after ventricular tachycardia (VT) ablation in patients with a septal substrate are poor.
OBJECTIVE: This study aimed to evaluate a strategy for septal VT ablation combining substrate imaging and a large-footprint dual-energy catheter.
METHODS: Patients presenting with drug-refractory VT in the setting of a predominantly septal substrate identified on preoperative imaging were prospectively included. Ablation targets were identified through a combination of imaging-based substrate identification and conventional endocardial mapping data. They were targeted using a large-footprint dual-energy catheter.
RESULTS: 12 procedures were performed in 10 consecutive patients. 9 of them had at least 1 previous failed ablation procedure, including nonstandard radiofrequency (RF) ablation strategies in 5. 6 of them were in a VT storm at the time of ablation. Substrate imaging using a computed tomography scan with late iodine acquisition showed intramural septal substrate in all. Noninducibility was reached in 83% of the procedures. 60% remained free from VT after the last procedure with a mean follow-up time of 9.9 ± 2.2 months. The ablation protocol was adapted during the study. In the last 5 patients, where the final optimized ablation protocol was used combining pulsed field and RF energy, 80% remained free from VT.
CONCLUSION: Septal VT ablation using a strategy combining substrate imaging and large-footprint dual-energy lattice-tip catheter leads to a high rate of noninducibility and good outcomes during short-term follow-up, especially when combining RF and pulsed field energy.
OBJECTIVE: This study aimed to evaluate a strategy for septal VT ablation combining substrate imaging and a large-footprint dual-energy catheter.
METHODS: Patients presenting with drug-refractory VT in the setting of a predominantly septal substrate identified on preoperative imaging were prospectively included. Ablation targets were identified through a combination of imaging-based substrate identification and conventional endocardial mapping data. They were targeted using a large-footprint dual-energy catheter.
RESULTS: 12 procedures were performed in 10 consecutive patients. 9 of them had at least 1 previous failed ablation procedure, including nonstandard radiofrequency (RF) ablation strategies in 5. 6 of them were in a VT storm at the time of ablation. Substrate imaging using a computed tomography scan with late iodine acquisition showed intramural septal substrate in all. Noninducibility was reached in 83% of the procedures. 60% remained free from VT after the last procedure with a mean follow-up time of 9.9 ± 2.2 months. The ablation protocol was adapted during the study. In the last 5 patients, where the final optimized ablation protocol was used combining pulsed field and RF energy, 80% remained free from VT.
CONCLUSION: Septal VT ablation using a strategy combining substrate imaging and large-footprint dual-energy lattice-tip catheter leads to a high rate of noninducibility and good outcomes during short-term follow-up, especially when combining RF and pulsed field energy.