Arrhythmias & electrophysiology
Substrate Characterization and Outcomes of Ventricular Tachycardia Ablation in Amyloid Cardiomyopathy: A Multicenter Study
Authors' conclusion
Catheter ablation can achieve control of recurrent VT/VF in more than half of patients with cardiac amyloidosis, and the reduction in VT/VF burden post-ablation may be relevant for quality of life.
Study context
- Population
- Patients with cardiac amyloidosis (ATTR n=16; light chain n=6) undergoing catheter ablation for ventricular tachycardia (VT)/VT/ventricular fibrillation (VF), 2013–2023mean age 68±10 years
- Participants
- 22 patients
- Outcome
- Recurrent VT/VF (efficacy); major procedure-related adverse events (safety)
- Follow-up
- During
Methodological detailsmulticentre, international, consecutive patients
- Multicentre
- International
- Consecutive patients
Main finding
As reported in the abstract
Sustained VT/VF recurrence · median follow-up 32 (14-42) months
Sustained VT/VF recurrence
9 patients
41%
Survival free from VT/VF recurrence at 36 months
56%
95% CI 36%–86%
Observational data: associations, not effects.
Further findings
| Outcome | HR | P value |
|---|---|---|
| Recurrent VT/VF by complete procedural success (multivariable)Multivariable analysis | 0.002 | P = 0.034 |
Complete procedural success
- Complete procedural success
- 16 patients (73%)
Per-patient ICD therapies, 6 months before vs after ablation
- Before: 6 [4-9] vs after: 0 [0-0]
- P < 0.001
Substrate
- Low-voltage areas in every patient, most commonly interventricular septum
- n=16
- Late potentials recorded
- 16 patients (73%)
- Mappable VTs originating from interventricular septum
- 12 of the 26 (46%)
- Inducible VTs per patient, median
- 1 (1-2)
Safety
- Major procedure-related adverse events
- 4 (18%)
Original publication
Substrate Characterization and Outcomes of Ventricular Tachycardia Ablation in Amyloid Cardiomyopathy: A Multicenter Study. Circ Arrhythm Electrophysiol. Published 22 August 2024. doi:10.
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