Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
J Am Coll Cardiol. 2016 Feb 16;67(6):674-683. doi: 10.1016/j.jacc.2015.11.041.
Radiofrequency catheter ablation is used to treat recurrent ventricular tachycardia (VT).
This study evaluated long-term safety and effectiveness of radiofrequency catheter ablation using an open-irrigated catheter.
Patients with sustained monomorphic ventricular tachycardia associated with coronary disease were analyzed for cardiovascular-specific adverse events within 7 days of treatment, hospitalization duration, 6-month sustained monomorphic ventricular tachycardia recurrence, quality of life measured by the Hospital Anxiety and Depression Scale, long-term (1-, 2-, and 3-year) survival, symptomatic VT control, and amiodarone use.
Overall, 249 patients, mean age 67.4 years, were enrolled. The cardiovascular-specific adverse events rate was 3.9% (9 of 233) with no strokes. Noninducibility of targeted VT was achieved in 75.9% of patients. Post-ablation median hospitalization was 2 days. At 6 months, 62.0% (114 of 184) of patients had no sustained monomorphic ventricular tachycardia recurrence; the proportion of patients with implantable cardioverter-defibrillator shocks decreased from 81.2% to 26.8% (p < 0.0001); the frequency of VT in implantable cardioverter-defibrillator patients with recurrences was reduced by ≥50% in 63.8% of patients; and the proportion with normal Hospital Anxiety and Depression Scale scores increased from 48.8% to 69.1% (p < 0.001). Patient-reported VT remained steady for 1, 2, and 3 years at 22.7%, 29.8%, and 24.1%, respectively. Amiodarone use and hospitalization decreased from 55% and 77.2% pre-ablation to 23.3% and 30.7%, 18.5% and 36.7%, 17.7% and 31.3% at 1, 2, and 3 years, respectively.
Radiofrequency catheter ablation reduced implantable cardioverter-defibrillator shocks and VT episodes and improved quality of life at 6 months. A steady 3-year nonrecurrence rate with reduced amiodarone use and hospitalizations indicate improved long-term outcomes. (NaviStar ThermoCool Catheter for Endocardial RF Ablation in Patients With Ventricular Tachycardia [THERMOCOOL VT]; NCT00412607).
射频导管消融术用于治疗复发性室性心动过速（VT）。
本研究评估了使用热盐水灌注导管进行射频导管消融的长期安全性和有效性。
对患有冠心病伴持续性单形性室性心动过速的患者进行治疗后 7 天内心血管特定不良事件、住院时间、6 个月持续性单形性室性心动过速复发、使用医院焦虑抑郁量表评估的生活质量、长期（1 年、2 年和 3 年）生存率、有症状 VT 控制和胺碘酮使用情况分析。
共有 249 名平均年龄 67.4 岁的患者入组。心血管特定不良事件发生率为 3.9%（233 例中的 9 例），无卒中发生。75.9%的患者实现了靶向 VT 的不可诱导性。消融后中位住院时间为 2 天。6 个月时，184 例患者中 62.0%（114 例）无持续性单形性室性心动过速复发；植入式心律转复除颤器电击次数从 81.2%降至 26.8%（p<0.0001）；复发性植入式心律转复除颤器患者的 VT 频率减少≥50%的比例为 63.8%；且 Hospital Anxiety and Depression Scale 评分正常的比例从 48.8%增加到 69.1%（p<0.001）。患者报告的 VT 在 1、2 和 3 年时分别稳定在 22.7%、29.8%和 24.1%。胺碘酮使用率和住院率分别从消融前的 55%和 77.2%降至 1 年后的 23.3%和 30.7%、2 年后的 18.5%和 36.7%、3 年后的 17.7%和 31.3%。
射频导管消融降低了植入式心律转复除颤器电击次数和 VT 发作次数，并改善了 6 个月时的生活质量。3 年时稳定的非复发率，同时降低了胺碘酮的使用和住院率，表明长期结果得到改善。（ThermoCool VT 研究；NCT00412607）。
