Tran Le Uyen Phuong, Kieu Ngoc Dung, Tran Cao Dat, Nguyen Tri-Thuc, Hoang Van Sy, Thai Truc Thanh
Department of Arrhythmology, Cho Ray Hospital, Ho Chi Minh City, Vietnam.
Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Vasc Health Risk Manag. 2025 Sep 8;21:773-784. doi: 10.2147/VHRM.S549819. eCollection 2025.
Advanced catheter ablation using three-dimensional electroanatomic mapping (EAM) has shown favorable outcomes in high-income countries, but real-world evidence from low- and middle-income settings is scarce. This study aimed to assess the clinical characteristics, procedural features, and outcomes of radiofrequency ablation using EAM in patients with ventricular tachycardia (VT) or premature ventricular contractions (PVCs) at a tertiary cardiac center in Vietnam.
We analyzed 233 patients who underwent VT and PVC ablation at Cho Ray Hospital from March 2021 to December 2023. Patients were categorized into two groups based on left ventricular ejection fraction (LVEF) with the cut-off value of 50%: reduced (LVEF < 50%, n = 39) and preserved (LVEF ≥ 50%, n = 194). Data on demographics, arrhythmia burden, ablation protocol, and follow-up outcomes were collected and compared.
Patients with reduced LVEF more frequently presented with ventricular tachycardia (23.1% vs 6.7%, p < 0.001), ischemic heart disease (23.1% vs 7.7%, p = 0.008), and were more likely to require irrigated catheters (46.2% vs 20.1%, p = 0.001). The PVC burden prior to ablation was significantly different between groups (36.3% ± 17.2 vs 27.8% ± 12.2, p = 0.014) and patients with reduced LVEF exhibited remarkable recovery after ablation, with LVEF improving from 33.7 ± 8.1 to 55.2 ± 9.1 ( < 0.001). The acute ablation success rate was 100% in both groups. The procedure demonstrated high levels of safety, with a non-severe complication rate of 4.7% (n = 11) and low radiation exposure (median 16 mGy [inter-quartile range: 11-26]).
Catheter ablation is highly effective and safe in treating ventricular arrhythmias across different LVEF, especially in ventricular arrhythmia-induced cardiomyopathy group, leading to rapid recovery of left ventricular function and reduction in arrhythmia burden. These findings provide important real-world evidence from a resource limited setting, providing multiple use of catheters and skin patches.
在高收入国家，使用三维电解剖标测（EAM）进行的高级导管消融已显示出良好的效果，但来自低收入和中等收入地区的真实世界证据却很少。本研究旨在评估越南一家三级心脏中心使用EAM对室性心动过速（VT）或室性早搏（PVC）患者进行射频消融的临床特征、手术特点和结果。
我们分析了2021年3月至2023年12月在胡志明市综合医院接受VT和PVC消融的233例患者。根据左心室射血分数（LVEF）将患者分为两组，临界值为50%：降低组（LVEF<50%，n = 39）和保留组（LVEF≥50%，n = 194）。收集并比较了人口统计学、心律失常负担、消融方案和随访结果的数据。
LVEF降低的患者更常出现室性心动过速（23.1%对6.7%，p<0.001）、缺血性心脏病（23.1%对7.7%，p = 0.008），并且更有可能需要使用灌注导管（46.2%对20.1%，p = 0.001）。消融前两组的PVC负担有显著差异（36.3%±17.2对27.8%±12.2，p = 0.014），LVEF降低的患者在消融后表现出显著恢复，LVEF从33.7±8.1提高到55.2±9.1（p<0.001）。两组的急性消融成功率均为100%。该手术显示出高度的安全性，非严重并发症发生率为4.7%（n = 11），辐射暴露低（中位数16 mGy[四分位间距：11 - 26]）。
导管消融在治疗不同LVEF的室性心律失常方面非常有效且安全，尤其是在室性心律失常性心肌病组，可导致左心室功能快速恢复和心律失常负担减轻。这些发现提供了来自资源有限环境的重要真实世界证据，实现了导管和皮肤贴片的多次使用。
