Computed tomography-guided vs conventional catheter ablation for ventricular tachycardia: the InEurHeart trial.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Sacher Frederic, Reichlin Tobias, Le Bloa Mathieu, Massoulie Gregoire, Waintraub Xavier, Maury Philippe, Scherr Daniel, Tixier Romain, Guy-Moyat Benoit, Duchateau Josselin, Meyer Christian, Sermesant Maxime, Plant Allan, Rousset Marine, Gunawardene Melanie A, Bronnec Noemie, Gandjbakhch Estelle, Sacristan Benjamin, Georget Aurore, Ditac Geoffroy, Azzouz Sanna, Haissaguerre Michel, Willems Stephan, Derval Nicolas, Tilz Roland Richard, Hocini Mélèze, Deneke Thomas, Pambrun Thomas, Rutten-van Mölken Maureen, Pürerfellner Helmut, Englert Florian, Sauer Elena, Jais Pierre, Benard Antoine, Cochet Hubert
Аннотация
METHODS: In 14 European centres, 113 patients with prior myocardial infarction and clinically significant VT were randomly assigned to CT-guided (n = 57) or conventional (n = 56) VT ablation. The primary objective was to demonstrate reduced procedural duration when using CT guidance. Secondary endpoints included efficacy (incidence and burden of ventricular arrhythmia), safety, as well as composite endpoints.
RESULTS: The primary endpoint showed a significant decrease in procedure time favouring CT-guided ablation: 149 ± 51 to 120 ± 50 min, -19% [95% confidence interval (CI) -32; -7]; P = .0027 in intention to treat, and 149 ± 51 to 107 ± 38 min, -28% (95% CI -40; -16); P < .0001 per protocol. Major adverse events occurred in two (3.5%) in the conventional group vs one (1.8%) in the CT-guided group [-1.8% (95% CI -7.9; 4.3)]. Ventricular tachycardia-free survival at 1 year was achieved in 37 (67.3%) patients for conventional vs 43 (76.8%) for CT-guided VT ablation [9.5% (95% CI -10.4; 29.4), P = NS]. Ventricular tachycardia burden was decreased by 90% in the CT-guided group.
CONCLUSIONS: In patients with ischaemic cardiomyopathy, CT-guided VT ablation reduces the procedure duration while maintaining a favourable efficacy and safety profile when compared with VT ablation without image integration.