Table 1:
Studies Investigating Different Substrate Ablation Strategies for VT
| Ablation Method | Study | Patients | Age | LVEF | Endpoint(s) [% of Patients Who Met the Endpoint(s)] | Epicardial and Endocardial Ablation/Mapping | 3D Mapping System |
|---|---|---|---|---|---|---|---|
| Linear ablation | Marchlinski et al. 200010 | 9 ICM and 7 NICM | 58 ± 16 years | 32% ± 15% | Noninducibility (47%) | 0/0 | CARTO® in 13 patients; none in 3 patients |
| Soejima et al. 200172 | 40 ICM | 67 ± 11 years | 28.9% | Noninducibility (58%) | 0/0 | CARTO® in 40 patients | |
| LP ablation | Volkmer et al. 200616 | 25 ICM | 65 ± 8 years | 30% ± 8% | Elimination of LPs and noninducibility (81%) | 0/0 | CARTO® in 25 patients |
| Arenal et al. 200373 | 21 ICM, 2 NICM, and 1 TOF | 66 ± 9 years | 30% ± 9% | Elimination of LPs and noninducibility (88%) | 0/0 | CARTO in 22 patients; none in 2 patients | |
| Nogami et al. 200874 | 18 ARVC | 48 ± 11 years | N/A | Change of isolated delayed component and noninducibility (33%) | 0/0 | CARTO® in 18 patients | |
| Garcia et al. 200975 | 13 ARVC | 43 ± 15 years | N/A | Elimination of LPs and noninducibility (85%) | 13/13 (1 underwent both types of mapping and epicardial ablation but not endocardial ablation) | CARTO® in 13 patients | |
| Bai et al. 201176 | 26 ARVC | 37 ± 11 years | 53% ± 10% | Elimination of LPs and noninducibility (100%) | 26/26 | CARTO® in 26 patients | |
| Vergara et al. 201277 | 36 ICM and 14 NICM | 66 ± 10 years | 32% ± 9% for ICM; 36% ± 10% for NICM | Elimination of LPs (84%) | 21/21 (3 underwent both types of mapping and epicardial ablation but not endocardial ablation) | CARTO®/NavX™ (number unknown) | |
| Arenal et al. 201378 | 59 ICM | 67 ± 9 years | 30% ± 11% | Elimination of LPs (78%) | 0/0 | CARTO® in 59 patients | |
| LAVA | Jaïs et al. 201219 | 56 ICM 14 NICM | 67 ± 11 years | 35% ± 10% | Elimination of LAVA (70%) and noninducibility | 17/21 | CARTO®/NavX™ (number unknown) |
| Wolf et al. 201820 | 159 ICM | 65 ± 11 years | 34% ± 11% | Elimination of LAVA (64%) and noninducibility | 27/46 | CARTO®/NavX™/Rhythmia™ in a total of 119 patients; none in 40 patients | |
| Scar homogenization | Di Biase et al. 201511 | 58 ICM | 67 ± 9 years | 32% ± 10% | Elimination of any abnormal potential ± loss of pacing capture (NA). | NA | CARTO® in 58 patients |
| Di Biase et al. 201217 | 43 ICM | 62 ± 8 years | 24% ± 8% | Elimination of any abnormal potential ± loss of pacing capture (NA). | 14/43 | CARTO® in 43 patients | |
| Scar dechanneling | Berruezo et al. 201238 | 11 ARVC | 42 ± 13 years | 55% ± 7% | Elimination of LP channels (NA) | 11/11 | CARTO® in 11 patients |
| Tung et al. 201381 | 15 ICM, 2 NICM, 2 ARVC, 1 sarcoid, 1 noncompaction, and 1 Chagas | 63 (52–70) years | 25% (25%–30%) | Change or elimination of LPs, failure to capture ± impedance drop of ; 10 Ω plus noninducibility (84%) | 9/9 | CARTO® in 11 patients patients/NavX™ in 10 patients | |
| Berruezo et al. 201582 | 75 ICM and 26 NICM | 65 ± 12 years | 36% ± 13% | Elimination of LP channels (84%) | N/A/27 | CARTO® in 96 patients/NavX™ in 5 patients | |
| Fernández-Armenta et al. 2016102 | 19 ICM and 5 NICM | 66 ± 11 years | 36% ± 14% | Elimination of delayed components (87.5%) | 5/5 (1 underwent epicardial ablation and mapping but not endocardial ablation or mapping) | CARTO/NavX (n = N/A) | |
| Core isolation | Tzou et al. 201579 | 32 ICM and 12 NICM | 63 ± 14 years | 31% ± 13% | Isolation with exit block (84%) | 5/6 | CARTO® in 44 patients |
| MRI-based scar dechanneling | Andreu et al. 201783 | 37 ICM and 17 NICM | 64 ± 11 years | 38% ± 12% | Elimination of LP channels detected on EAM guided by CMR (84%) | 18/18 | CARTO® in 54 patients |
ARVC: arrhythmogenic right ventricular cardiomyopathy; CMR: cardiac magnetic resonance imaging; EAM: electroanatomical mapping; Epi: epicardial; ICM: ischemic cardiomyopathy; LAVA: local abnormal ventricular activity; LP: late potential; LVEF: left ventricular ejection fraction; LP: late potential; MRI: magnetic resonance imaging; N/A: not available; NICM: nonischemic cardiomyopathy; noncompaction: noncompaction cardiomyopathy; RF: radiofrequency; sarcoid: cardiac sarcoidosis; TOF: tetralogy of Fallot; VT: ventricular tachycardia. CARTO® is the property of Biosense Webster, Diamond Bar, CA, USA. NavX™ is the property of Abbott Laboratories, Chicago, IL, USA. Rhythmia™ is the property of Boston Scientific, Natick, MA, USA.