Benjamin Berte1, Hubert Cochet2, Lam Dang3, Saagar Mahida4, Federico Moccetti5, Gabi Hilfiker5, Joel Bondietti6, Frank Ruschitzka7, Pierre Jaïs2, Christoph Scharf7, Richard Kobza5. 1. Heart Centrum, Luzerner Kantonsspital, Spitalstrasse, 6000, Luzern, Switzerland. Benjamin.berte@luks.ch. 2. University of Bordeaux; IHU LIRYC ANR-10-IAHU-04 ; Equipex MUSIC ANR-11-EQPX-0030, CHU Bordeaux, Bordeaux, France. 3. Herzgefässzentrum, Klinik Im Park, Zürich, Switzerland. 4. Liverpool Heart and Chest Hospital, Thomas Dr, Liverpool, L14 3PE, UK. 5. Heart Centrum, Luzerner Kantonsspital, Spitalstrasse, 6000, Luzern, Switzerland. 6. Biosense Webster, Johnson and Johnson, Zug, Switzerland. 7. Universitätsspital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
Abstract
PURPOSE: The aim of this study was to analyze the feasibility and reproducibility of using image integration software at a remote setting over the MUSIC network to perform image-guided VT ablation. Furthermore, we analyzed the efficacy of a focused workflow with electroanatomical mapping (EAM) limited to imaging-defined scar. METHODS: In a prospective two-centre study, consecutive patients undergoing image integration-guided VT ablation (magnetic resonance [DE-MRI] and/or multidetector computed tomography [MDCT]) were included. Patients were divided into two groups (Group 1, complete EAM; Group 2, EAM limited to imaging-defined substrate). RESULTS: Forty-nine patients (62 ± 15 years; 90% male; LVEF 41 ± 14%; ischemic 69%) who underwent image integration-guided VT ablation were included (MDCT 98%; DE-MRI in 35%). Total procedure time was 172 ± 48 min (ablation 31 ± 17 min; fluoroscopy 23 ± 13 min). Procedure time was shorter in Group 2 as compared to Group 1 (Group 2 [n = 26] vs. Group 1 [n = 23]; procedure time: 151 ± 33 vs. 180 ± 53 min, P = 0.01). Non-inducibility of all VT was achieved in 37 (76%), with no difference between Group 1 and 2 (Group 2 vs. Group 1; VT non-inducibility 71 vs. 74%, P = 0.8). During a follow-up period of 19 ± 8 months, 13 patients (27%) had a VT recurrence. Two patients (4%) died during follow-up. There were no differences in VT-free survival between Group 1 and Group 2 (p = 0.77). CONCLUSION: Image-integrated VT ablation is feasible through a network between highly experienced centers and remotely located centers. Focused image integration-guided VT ablation is associated with short and predictable procedure duration, achieving high-long term success rates.
PURPOSE: The aim of this study was to analyze the feasibility and reproducibility of using image integration software at a remote setting over the MUSIC network to perform image-guided VT ablation. Furthermore, we analyzed the efficacy of a focused workflow with electroanatomical mapping (EAM) limited to imaging-defined scar. METHODS: In a prospective two-centre study, consecutive patients undergoing image integration-guided VT ablation (magnetic resonance [DE-MRI] and/or multidetector computed tomography [MDCT]) were included. Patients were divided into two groups (Group 1, complete EAM; Group 2, EAM limited to imaging-defined substrate). RESULTS: Forty-nine patients (62 ± 15 years; 90% male; LVEF 41 ± 14%; ischemic 69%) who underwent image integration-guided VT ablation were included (MDCT 98%; DE-MRI in 35%). Total procedure time was 172 ± 48 min (ablation 31 ± 17 min; fluoroscopy 23 ± 13 min). Procedure time was shorter in Group 2 as compared to Group 1 (Group 2 [n = 26] vs. Group 1 [n = 23]; procedure time: 151 ± 33 vs. 180 ± 53 min, P = 0.01). Non-inducibility of all VT was achieved in 37 (76%), with no difference between Group 1 and 2 (Group 2 vs. Group 1; VT non-inducibility 71 vs. 74%, P = 0.8). During a follow-up period of 19 ± 8 months, 13 patients (27%) had a VT recurrence. Two patients (4%) died during follow-up. There were no differences in VT-free survival between Group 1 and Group 2 (p = 0.77). CONCLUSION: Image-integrated VT ablation is feasible through a network between highly experienced centers and remotely located centers. Focused image integration-guided VT ablation is associated with short and predictable procedure duration, achieving high-long term success rates.
Authors: Richard G Bennett; Timothy Campbell; Ashish Sood; Ashwin Bhaskaran; Kasun De Silva; Lloyd Davis; Pierre Qian; Gopal Sivagangabalan; Mark J Cooper; Clara K Chow; Aravinda Thiagalingam; A Robert Denniss; Stuart P Thomas; Eddy Kizana; Saurabh Kumar Journal: Heliyon Date: 2021-12-06
Authors: Donald S Rubenstein; Benjamin B Holmes; Joseph A Manfredi; Matthew S McKillop; Peter C Netzler; Chad C Ward Journal: J Interv Card Electrophysiol Date: 2022-03-08 Impact factor: 1.759