Minerva Cardioangiologica 2020 Sep 29

DOI: 10.23736/S0026-4725.20.05128-2

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Factors associated with recurrent postinfarction ventricular tachycardia following ablation: a meta-analysis

Jakrin KEWCHAROEN ¹ ✉, Narut PRASITLUMKUM ¹, Sittinop TITICHOATRATTANA ², Chutikarn WITTAYALIKIT ², Angkawipa TRONGTORSAK ², Chanavuth KANITSORAPHAN ¹, Prapaipan PUTTHAPIBAN ³, Kittika POONSOMBUDLERT ¹, Pattara RATTANAWONG ^{4, 5}, Eugene H. CHUNG ⁶

¹ University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA; ² Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; ³ Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA; ⁴ Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA; ⁵ Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; ⁶ Department of Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

BACKGROUND: Ablation of ventricular tachycardia is the main therapy for patients with drug-refractory VT. Although evidence suggests that VT ablation could lower the incidence of recurrent VT, many cases still develop VT in follow-up. In this study, we performed a systematic review and meta-analysis to examine risk factors for recurrent VT in patients with postinfarction VT who underwent VT ablation.
METHODS: We comprehensively searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were cohort studies, experimental trials, or randomized controlled trials that evaluate the risk of recurrent VT in postinfarction VT patients who underwent VT ablation. Data from each study were combined using random-effects.
RESULTS: Thirteen studies involving 1,803 postinfarction patients who underwent VT ablation were included. Inducibility after the procedure (pooled HR=1.71, p<0.001), lower baseline left ventricular ejection fraction (LVEF) (pooled HR=0.98, p<0.001) and higher baseline New York Heart Association (NYHA) classification (pooled HR=1.34, p=0.003) were significantly associated with VT recurrence during the follow-up. There was no significant association between age, gender or diabetes mellitus and VT recurrence.
CONCLUSIONS: Our meta-analysis demonstrated that inducibility after the procedure, lower baseline LVEF and higher baseline NYHA classification were associated with an increased risk of VT recurrence in postinfarction VT patients who underwent VT ablation.

KEY WORDS: Ventricular tachycardia; Myocardial ischemia; Coronary artery disease; Ventricular ablation