JACC. Clinical electrophysiology · 2025
Outcomes of Scar-Related Ventricular Tachycardia Ablation With Percutaneous Left Ventricular Assist Device Support.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kawamura Iwanari, Koruth Jacob S, Kusa Shigeki, Iwasawa Jin, Lam Jeff, Ellsworth Betsy, Watanabe Keita, Nies Moritz, Lampert Joshua, Maan Abhishek, Musikantow Daniel R, Turagam Mohit K, Moss Noah, Whang William, Miller Marc A, Reddy Vivek Y, Dukkipati Srinivas
Аннотация
BACKGROUND: Percutaneous left ventricular assist devices (pLVADs) are often used in critically ill patients undergoing scar-related ventricular tachycardia (VT) ablation. However, there are no randomized controlled trials evaluating their benefits.
OBJECTIVES: The goal of this study was to compare outcomes between pLVAD- and non-pLVAD-supported VT ablation using a propensity score matching analysis.
METHODS: This retrospective analysis comprised 481 scar-related VT patients who underwent catheter ablation (175 pLVAD and 306 non-pLVAD). A 1:1 propensity score matching was conducted to balance baseline characteristics for comparison of procedural and long-term outcomes.
RESULTS: A propensity score analysis generated 115 matched pairs in each group. Baseline characteristics of the matched cohorts were comparable (mean left ventricular ejection fraction 27%, 40% NYHA functional class ≥III, and 36% electrical storm). Compared with the non-pLVAD, more patients in the pLVAD group had at least 1 VT termination during ablation. Despite including a higher use of advanced ablation strategies and a longer procedure time, the pLVAD group had a postprocedural VT inducibility similar to that of the non-pLVAD group. The incidence of periprocedural major complications was higher among pLVAD patients (29.6% vs 13.9%; P = 0.004), largely driven by vascular complications requiring intervention and periprocedural heart failure. During a median follow-up of 326 days, Kaplan-Meier curves showed no statistically significant differences in composite outcome (hospitalization for VT or worsening heart failure requiring hospitalization, LVAD implantation, orthotopic heart transplantation, and all-cause mortality), and VT recurrence.
CONCLUSIONS: The use of pLVADs during VT ablation is associated with longer procedures and higher procedural complications without any benefit in acute or long-term outcomes.
OBJECTIVES: The goal of this study was to compare outcomes between pLVAD- and non-pLVAD-supported VT ablation using a propensity score matching analysis.
METHODS: This retrospective analysis comprised 481 scar-related VT patients who underwent catheter ablation (175 pLVAD and 306 non-pLVAD). A 1:1 propensity score matching was conducted to balance baseline characteristics for comparison of procedural and long-term outcomes.
RESULTS: A propensity score analysis generated 115 matched pairs in each group. Baseline characteristics of the matched cohorts were comparable (mean left ventricular ejection fraction 27%, 40% NYHA functional class ≥III, and 36% electrical storm). Compared with the non-pLVAD, more patients in the pLVAD group had at least 1 VT termination during ablation. Despite including a higher use of advanced ablation strategies and a longer procedure time, the pLVAD group had a postprocedural VT inducibility similar to that of the non-pLVAD group. The incidence of periprocedural major complications was higher among pLVAD patients (29.6% vs 13.9%; P = 0.004), largely driven by vascular complications requiring intervention and periprocedural heart failure. During a median follow-up of 326 days, Kaplan-Meier curves showed no statistically significant differences in composite outcome (hospitalization for VT or worsening heart failure requiring hospitalization, LVAD implantation, orthotopic heart transplantation, and all-cause mortality), and VT recurrence.
CONCLUSIONS: The use of pLVADs during VT ablation is associated with longer procedures and higher procedural complications without any benefit in acute or long-term outcomes.