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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-10212022-082506


Thesis type
Tesi di specializzazione (4 anni)
Author
PAROLLO, MATTEO
URN
etd-10212022-082506
Thesis title
Imaging-guided ventricular tachycardia ablation: preliminary experience from a multicenter clinical trial
Department
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Course of study
MALATTIE DELL'APPARATO CARDIOVASCOLARE
Supervisors
relatore Prof. De Caterina, Raffaele
relatore Dott. Zucchelli, Giulio
Keywords
  • sudden cardiac death
  • artificial intelligence
  • electrophysiology
  • magnetic resonance imaging
  • ventricular tachycardia
Graduation session start date
08/11/2022
Availability
Withheld
Release date
08/11/2092
Summary
Radiofrequency catheter ablation is a safe and effective treatment for scar-related ventricular arrhythmias. Preliminary studies have shown that real time integration of late gadolinium enhancement magnetic resonance images (LGE-CMR) with electroanatomical mapping (EAM) systems can lead to improved procedural efficacy, efficiency and safety.
We present the preliminary results of a prespecified interim analysis of the VOYAGE trial, a prospective, randomized, multicenter controlled open label study aimed at comparing in terms of efficacy, efficiency and safety a CMR aided/guided approach to standard EAM-guided ventricular tachycardia (VT) ablation.
Patients with an ICD or with ICD implantation expected within 1 month with structural left ventricle heart disease and scar-related VT were randomized to a CMR-guided or a CMR-aided approach with LGE-CMR image post-processing performed with an artificial intelligence powered software (ADAS3D), while subjects unsuitable for imaging or with image quality deemed not sufficient for postprocessing were allocated to standard of care ablation.
Primary endpoint was defined as VT recurrence within 12-months follow up (either sustained or requiring ICD therapy), with a 1-month blanking period. Secondary endpoints included procedural efficiency, safety and impact on quality of life.
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