Nakasone Kazutaka, Fukuzawa Koji, Kiuchi Kunihiko, Takami Mitsuru, Sakai Jun, Nakamura Toshihiro, Yatomi Atsusuke, Sonoda Yusuke, Takahara Hiroyuki, Yamamoto Kyoko, Suzuki Yuya, Tani Ken-Ichi, Iwai Hidehiro, Nakanishi Yusuke, Hirata Ken-Ichi
Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan.
Section of Arrhythmia, Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine Kobe Japan.
J Arrhythm. 2022 Nov 15;39(1):52-60. doi: 10.1002/joa3.12796. eCollection 2023 Feb.
Ventricular tachycardia (VT) non-inducibility at the end of ablation is associated with a less likely VT recurrence. However, it is not clear whether we should use VT non-inducibility as a routine end point of VT ablation. The aim of this study was to evaluate VT recurrence in patients in whom VT non-inducibility was not achieved at the end of the radiofrequency (RF) ablation and the factors attributing to the VT recurrence.
We analyzed that 62 patients in whom VT non-inducibility was not achieved at the end of the RF ablation were studied.
Over 2 years, 22 (35%) of the cases had VT recurrences. A multivariate analysis showed that an LVEF ≥35% (HR: 0.19; 95% CI: 0.06-0.49; < .01) and elimination of the clinical VT as an acute ablation efficacy (HR: 0.23; 95% CI: 0.04-0.81; = .02) were independent predictors of fewer VT recurrences. RF ablation was associated with a 91.1% reduction in VT episodes.
Even if VT non-inducibility was not achieved, patients with an LVEF ≥35% or in whom the clinical VT could be eliminated might be prevented from having VT recurrences. The validity of the VT non-inducibility of any VT should be evaluated considering each patient's background and the results of the procedure.
消融结束时室性心动过速（VT）不能被诱发与VT复发可能性较低相关。然而，尚不清楚是否应将VT不能被诱发作为VT消融的常规终点。本研究的目的是评估在射频（RF）消融结束时未实现VT不能被诱发的患者的VT复发情况以及导致VT复发的因素。
我们分析了62例在RF消融结束时未实现VT不能被诱发的患者。
在超过2年的时间里，22例（35%）病例出现VT复发。多因素分析显示，左心室射血分数（LVEF）≥35%（风险比：0.19；95%置信区间：0.06 - 0.49；P <.01）以及消除临床VT作为急性消融疗效（风险比：0.23；95%置信区间：0.04 - 0.81；P = 0.02）是VT复发较少的独立预测因素。RF消融使VT发作减少了91.1%。
即使未实现VT不能被诱发，LVEF≥35%或能够消除临床VT的患者可能会预防VT复发。应根据每位患者的背景和手术结果评估任何VT不能被诱发的有效性。
