Electrophysiologic Substrate, Safety, Procedural Approaches, and Outcomes of Catheter Ablation for Ventricular Tachycardia in Patients After Aortic Valve Replacement

摘要: Abstract Objectives This study sought to investigate the substrate, procedural strategies, safety, and outcomes of catheter ablation (CA) for ventricular tachycardia (VT) in patients with aortic valve replacement (AVR). Background VT AVR is challenging, particularly when mapping periaortic region are necessary. Methods We identified consecutive mechanical, bioprosthetic, transcatheter who underwent CA refractory antiarrhythmic drugs analyzed approach LV access, complications, long-term outcomes. Results Overall, 29 (87% men, mean age 67.9 ± 9.8 years, left ejection fraction 39 10%) prior (13 15 1 AVR) 40 ablations from 2004 2016. Left-sided mapping/CA was performed 27 (36 procedures). Access retrograde 11 procedures (all bioprosthetic), transseptal 24 mechanical; 10 bioprosthetic; AVR), or transventricular septal 1. Periaortic bipolar unipolar scar detected all whom detailed performed. Clinical circuit(s) involved (34%), 2 (7%) had bundle branch re-entry VT, 17 (59%) substrate unrelated AVR. There were major complications (both related vascular access). Only (9.1%) recurrence. Over median follow-up 12.8 months, died (none as a result recurrent VT). Conclusions Whereas most undergoing after AVR, universally present can be mechanism. safely excellent elimination.