Safety and effectiveness of intracardiac echocardiography in ventricular tachycardia ablation: a nationwide observational study
- 21 January 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Heart and Vessels
- Vol. 36 (7), 1009-1015
- https://doi.org/10.1007/s00380-020-01766-y
Abstract
Intracardiac echocardiography (ICE) utilized in conjunction with three-dimensional (3-D) mapping systems could enhance ventricular tachycardia (VT) ablation procedures. ICE has been increasingly used in VT ablation; however, the safety and effectiveness of VT ablation under the combined use of ICE remains unclear. The present study aimed to analyze the safety and short-term effects of VT ablation with or without ICE. We retrospectively enrolled patients who underwent initial VT ablation with a combination of ICE and a 3-D mapping system within 3 days of hospitalization and discharged from April 2011 to March 2017 using a nationwide Japanese inpatient database. Following enrollment, we conducted a propensity score-matching analysis to compare safety (in-hospital complications) and effectiveness (readmission within 30 days after discharge due to cardiovascular disease and readmissions within 30 days for repeat VT ablations) between patients who underwent VT ablation with (ICE group) and without ICE (non-ICE group). 3-D mapping systems were applied to both groups. We identified 5,804 eligible patients (1,272 and 4,532 patients in the ICE and non-ICE groups, respectively). One-to-one propensity score matching created a total of 1,147 pairs between the ICE and non-ICE groups. The ICE group showed a significantly lower prevalence of cardiac tamponade than the non-ICE group. There were no significant differences observed between the two groups regarding other outcomes concerning safety and effectiveness. Ventricular tachycardia ablation with ICE used in combination with a 3-D mapping system may reduce cardiac tamponade; however, no additional clinical advantages were noted in terms of safety and effectiveness.Keywords
Funding Information
- Ministry of Health, Labour and Welfare (19AA2007 and 20AA2005)
This publication has 25 references indexed in Scilit:
- Effect of weekend admission for acute myocardial infarction on in-hospital mortality: A retrospective cohort studyInternational Journal of Cardiology, 2014
- Bipolar irrigated radiofrequency ablation: A therapeutic option for refractory intramural atrial and ventricular tachycardia circuitsHeart Rhythm, 2012
- Assessing Epicardial Substrate Using Intracardiac Echocardiography During VT AblationCirculation: Arrhythmia and Electrophysiology, 2011
- An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational StudiesMultivariate Behavioral Research, 2011
- Image Integration Using Intracardiac Ultrasound and 3D Reconstruction for Scar Mapping and Ablation of Ventricular TachycardiaJournal of Cardiovascular Electrophysiology, 2010
- Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity‐score matched samplesStatistics in Medicine, 2009
- Irrigated Radiofrequency Catheter Ablation Guided by Electroanatomic Mapping for Recurrent Ventricular Tachycardia After Myocardial InfarctionCirculation, 2008
- Real-time integration of 2D intracardiac echocardiography and 3D electroanatomical mapping to guide ventricular tachycardia ablationHeart Rhythm, 2008
- Three-Dimensional Ultrasound for Image-Guided Mapping and InterventionCirculation: Arrhythmia and Electrophysiology, 2008
- Two-dimensional echocardiography and infarct size: relationship of regional wall motion and thickening to the extent of myocardial infarction in the dog.Circulation, 1981