Ventricular tachycardia characteristics and outcomes with catheter ablation vs. antiarrhythmic therapy: insights from the VANISH trial
Ventricular tachycardia characteristics and outcomes with catheter ablation vs. antiarrhythmic therapy: insights from the VANISH trial
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DOI：
10.1093/europace/euab328
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发表时间：
2022-07-21
期刊：
影响因子：
6.1
通讯作者：
Sapp, John L.
中科院分区：
文献类型：
--
作者：
Deyell, Marc W.;Doucette, Steve;Sapp, John L.
目的 对于室性心动过速 (VT) 和既往心肌梗塞 (MI) 患者，导管消融优于升级抗心律失常药物。然而，尚不确定临床 VT 特征是否会影响治疗选择。本研究的目的是评估电风暴的表现和临床室速周期长度是否可以预测消融与升级抗心律失常治疗的反应。方法和结果 参加缺血性心脏病室性心动过速消融与升级抗心律失常药物治疗 (VANISH) 试验的所有患者均被纳入。评估了 VT 周期长度和电风暴表现与死亡、随后的 VT 风暴或适当的 ICD 电击等主要结局之间的关联。在 259 名患者的研究人群中，对于 VT 周期长度 > 400 ms 的患者，升级抗心律失常药物治疗的结果更差 [
Aims Catheter ablation is superior to escalated antiarrhythmic drugs among patients with ventricular tachycardia (VT) and prior myocardial infarction (MI). However, it is uncertain whether clinical VT characteristics, should influence choice of therapy. The purpose of this study was to evaluate whether presentation with electrical storm and the clinical VT cycle length predicted response to ablation vs. escalated antiarrhythmic therapy. Methods and results All patients enrolled in the Ventricular Tachycardia Ablation vs. Escalated Antiarrhythmic Drug Therapy in Ischaemic Heart Disease (VANISH) trial were included. The association between VT cycle length and presentation with electrical storm and the primary outcome of death, subsequent VT storm or appropriate ICD shock was evaluated. Among the study population of 259 patients, escalated antiarrhythmic drug therapy had worse outcomes for those presenting with a VT cycle length >400 ms [