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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-12122021-185253


Thesis type
Tesi di specializzazione (4 anni)
Author
SBRAGI, SARA
URN
etd-12122021-185253
Thesis title
Outcomes and predictors of ventricular tachycardia ablation efficacy in a tertiary referral centre
Department
PATOLOGIA CHIRURGICA, MEDICA, MOLECOLARE E DELL'AREA CRITICA
Course of study
MALATTIE DELL'APPARATO CARDIOVASCOLARE
Supervisors
relatore Prof. De Caterina, Raffaele
relatore Dott.ssa Bongiorni, Maria Grazia
Keywords
  • ventricular tachycardia; catheter ablation
Graduation session start date
07/01/2022
Availability
Withheld
Release date
07/01/2092
Summary
Ventricular Tachycardia (VT) ablation has emerged in last decades as an increasingly used therapeutic approach for the treatment of VT. In our study, we analyzed several aspects of a large single center cohort of patients who underwent VT ablation (99 patients, 17% female, mean age 65±15 y, mean LVEF 44 ± 13%). 40% of the patients presented in electrical storm. We wanted to focus on safety issues and efficacy results, as well as analyze potential predictors of efficacy in terms of VT recurrence. Overall, in our experience VT ablation appeared as a safe and effective procedure, with no intraoperative life-threatening complications and a rate of major adverse events in line with the main previous studies (3%). During a median follow up of 593 days (IQR [181-985]), 60% of the patients were free from VT recurrence. There was no significant difference in VT recurrence between ischemic and non ischemic patients (40% of VT recurrence in ischemic patients and 46% in non ischemic patients; p 0,576). In 75% of the patients that were not in anticoagulant treatment before ablation, a temporary post-procedure anticoagulation was established. In 20% of the patients in amiodarone therapy, drug treatment was disrupted. Interestingly, substrate VT ablation approach via conducting channel technique was a significant predictor of VT ablation efficacy at univariate analysis (H.R. 0,208, 95%C.I 0,500-0,868, p 0,031), with a trend towards significance at multivariate analysis (H.R. 0,250, 95%C.I 0,058-1,073, p 0,062).
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