http://www.cardiophile.net Archive of Cardiophile MD Wed, 16 Jun 2010 00:06:48 +0000 en hourly 1 http://wordpress.org/?v=3.0 http://www.cardiophile.net/2008/12/catheter-ablation-for-post-myocardial-infarction-ventricular-tachycardia.html http://www.cardiophile.net/2008/12/catheter-ablation-for-post-myocardial-infarction-ventricular-tachycardia.html#comments Wed, 24 Dec 2008 00:57:50 +0000 Johnson Francis http://www.cardiophile.net/?p=61 Catheter ablation for post myocardial infarction ventricular tachycardia guided by electroanatomic mapping has been evaluated recently by The Multicenter Thermocool Ventricular Tachycardia Ablation Trial and published in Circulation. 2008;118:2667-2668. This is one of the largest studies of radiofrequency catheter ablation for monomorphic ventricular tachycardia caused by coronary artery disease, which evaluated 231 patients from about 15 centres in the United States of America. They used a saline irrigated catheter along with electranatomic mapping system to facilitate substrate mapping during sinus rhythm. This study was remarkable in that patients were not excluded because of multiple ventricular tachycardias or unmappable ventricular tachycardia, which was in fact present in 69% of patients. All inducible ventricular tachycardias could be abolished in 49% of patients. 53% of patients was free fo recurrent incessant or intermittent ventricular tachycardia after 6 months, which was the primary end point. One year mortality rate was 18% and 72.5% of deaths were due to arrhythmias or heart failure. Procedural mortality was 3% and there was no strokes during the procedure. This study has established a role for post myocardial infarction ventricular tachycardia even in those with multiple and unmappable ventricular tachycardia. Further studies are needed in this group of high risk patients.

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