open access

Vol 67, No 2 (2009)
Other
Published online: 2009-02-18
Submitted: 2012-12-28
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Original article
Outcomes of a single centre registry of patients with ischaemic heart disease, qualified for an RF ablation of ventricular arrhythmia after ICD intervention

Łukasz Szumowski, Andrzej Przybylski, Aleksander Maciąg, Paweł Derejko, Robert Bodalski, Joanna Zakrzewska, Michał Orczykowski, Ewa Szufladowicz, Hanna Szwed, Franciszek Walczak
Kardiol Pol 2009;67(2):123-127.

open access

Vol 67, No 2 (2009)
Other
Published online: 2009-02-18
Submitted: 2012-12-28

Abstract


Background and aim: Reduction of ICD interventions improves the quality of life and possibly reduces mortality. Ablation reduces ICD interventions in patients with ablatable arrhythmia, but its effectiveness needs to be proven for patients with coronary artery disease (CAD) regardless of the type of arrhythmia. Our study was designed to address this issue, but it had to be terminated due to recruitment problems. The reasons for early termination are described in this paper.
Methods: Patients with CAD and implanted ICD, who within the past three months survived an episode of VT/VF, were selected for this study. Patients were to be randomised for ablation or pharmacotherapy. A group of 209 patients was screened between June and December of 2007.
Results: Out of 209 patients, 39 (18.7%) had appropriate ICD therapy during the last three months and were potentially eligible for the trial. Out of 39 patients, 34 could not be randomised, due to the presence of exclusion criteria (n-25) or consent refusal (n-9). Previous ablation (n-10), left ventricular thrombus (n-3) or presence of mitral or aortic artificial valve (n-3) were the most frequent exclusion criteria. During follow-up of 12 months one patient required ablation due to frequent ICD discharges. From the five randomised patients, two were randomised to ablation and three to the pharmacotherapy arm.
Conclusions: 1. Ablation might not be suitable as a routine treatment for all patients with ICD interventions, as a significant group prefers not to undergo RF ablation as a routine treatment or there are contraindications for the ablation. 2. There are obstacles in prospective and randomised evaluation of the role of ablation in patients with CAD and ICD interventions, which are related both to patients’ medical conditions and to patients’ will. These limitations should be taken into account when designing further studies.

Abstract


Background and aim: Reduction of ICD interventions improves the quality of life and possibly reduces mortality. Ablation reduces ICD interventions in patients with ablatable arrhythmia, but its effectiveness needs to be proven for patients with coronary artery disease (CAD) regardless of the type of arrhythmia. Our study was designed to address this issue, but it had to be terminated due to recruitment problems. The reasons for early termination are described in this paper.
Methods: Patients with CAD and implanted ICD, who within the past three months survived an episode of VT/VF, were selected for this study. Patients were to be randomised for ablation or pharmacotherapy. A group of 209 patients was screened between June and December of 2007.
Results: Out of 209 patients, 39 (18.7%) had appropriate ICD therapy during the last three months and were potentially eligible for the trial. Out of 39 patients, 34 could not be randomised, due to the presence of exclusion criteria (n-25) or consent refusal (n-9). Previous ablation (n-10), left ventricular thrombus (n-3) or presence of mitral or aortic artificial valve (n-3) were the most frequent exclusion criteria. During follow-up of 12 months one patient required ablation due to frequent ICD discharges. From the five randomised patients, two were randomised to ablation and three to the pharmacotherapy arm.
Conclusions: 1. Ablation might not be suitable as a routine treatment for all patients with ICD interventions, as a significant group prefers not to undergo RF ablation as a routine treatment or there are contraindications for the ablation. 2. There are obstacles in prospective and randomised evaluation of the role of ablation in patients with CAD and ICD interventions, which are related both to patients’ medical conditions and to patients’ will. These limitations should be taken into account when designing further studies.
Get Citation

Keywords

ventricular tachycardia; radiofrequency ablation; implantable cardioverter defibrillator

About this article
Title

Original article
Outcomes of a single centre registry of patients with ischaemic heart disease, qualified for an RF ablation of ventricular arrhythmia after ICD intervention

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 67, No 2 (2009)

Pages

123-127

Published online

2009-02-18

Bibliographic record

Kardiol Pol 2009;67(2):123-127.

Keywords

ventricular tachycardia
radiofrequency ablation
implantable cardioverter defibrillator

Authors

Łukasz Szumowski
Andrzej Przybylski
Aleksander Maciąg
Paweł Derejko
Robert Bodalski
Joanna Zakrzewska
Michał Orczykowski
Ewa Szufladowicz
Hanna Szwed
Franciszek Walczak

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