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The use of imaging guidance in ventricular tachycardia (VT) ablation for patients with ischaemic heart disease is associated with higher VT-free survival.
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This is the first study that demonstrates a true large-scale benefit of visualising myocardial scar and integrating imaging in a VT ablation procedure.
Introduction
Methods
Data sources and search strategy
Study selection and data extraction criteria
Risk of bias assessments for the included clinical studies
Data synthesis and analysis
Results
Identification of relevant studies
General characteristics of the included studies
Publication | Method of study | Patients with ischaemic VT | FU duration (months) | ||
---|---|---|---|---|---|
Author | Year | Country | |||
A. Image-guided | |||||
Neijm [4] | 2015 | USA | OS, Co, SC | 8 | 17 |
Acosta [5] | 2016 | Spain | OS, Co, SC | 58 | 23 |
Yamashita [6] | 2016 | France | OS, Co, SC | 67 | 17 |
Yamashita [7] | 2016 | France | OS, Co, SC | 54 | 28 |
Andreu [8] | 2017 | Spain | Os, Co, SC | 37 | 20 |
B. Non-image-guided | |||||
Di Biase [9] | 2012 | Hungary, Italy, USA | OS, Co, MC | 92 | 25 |
Dinov [10] | 2012 | Germany | OS, Co, SC | 102 | 14 |
Arenal [11] | 2013 | Spain | OS, Co, SC | 59 | 38 |
Ghanem [12] | 2013 | Egypt | OS, Co, SC | 22 | 12 |
Tung [13] | 2013 | USA | OS, Co, SC | 69 | 12 |
Aryana [15] | 2014 | USA | OS, Co, MC | 36 | 19 |
Goya [16] | 2014 | Japan | OS, Co, SC | 51 | 41 |
Mork [17] | 2014 | Denmark | OS, Co, SC | 90 | 39 |
Saggu [18] | 2014 | India | OS, Co, SC | 5 | 46 |
Silberbauer [19] | 2014 | Italy | OS, Co, SC | 160 | 47 |
Tilz [20] | 2014 | Germany | OS, Co, SC | 12 | 40 |
Avila [2] | 2015 | Spain | OS, Co, SC | 46 | 32 |
Clemens [21] | 2015 | Czech Republic | OS, Co, SC | 31 | 46 |
De Riva [22] | 2015 | The Netherlands | OS, Co, SC | 91 | 23 |
Di Biase [23] | 2015 | China, Europa, USA | RCT, MC | 118 | 12 |
Izguierdo [24] | 2015 | Spain | OS, Co, SC | 50 | 13 |
Luther [25] | 2015 | UK | OS, Co, SC | 24 | 24 |
Pioretti [26] | 2015 | USA | OS, Co, SC | 87 | 54 |
Siontis [27] | 2015 | Europa, USA | OS, Co, MC | 1412 | 56 |
Tsiarchis [26] | 2015 | Italy | OS, Co, SC | 100 | 52 |
Tung [29] | 2015 | USA | OS, Co, MC | 1095 | 12 |
Yokokowa [14] | 2015 | USA | OS, Co, SC | 906 | 35 |
Acosta [30] | 2016 | Spain | OS, Co, SC | 44 | 46 |
Dinov [31] | 2016 | Germany | OS, Co, SC | 50 | 12 |
Frankel [32] | 2016 | Italy, Japan, USA | OS, Co, MC | 1095 | 12 |
Fukunaga [33] | 2016 | Japan | OS, Co, SC | 51 | 40 |
Ozcan [34] | 2016 | North America | OS, Co, SC | 44 | 28 |
Sapp [35] | 2016 | Europe, USA | RCT, MC | 132 | 28 |
Skoda [36] | 2016 | Czech Republic, Germany, USA | OS, Co, MC | 53 | 12 |
Jin [37] | 2017 | China, Denmark | OS, Co, MC | 54 | 17 |
Kuck [38] | 2017 | Germany | RCT, MC | 60 | 28 |
Kuroki [39] | 2017 | Japan | OS, Co, MC | 109 | 24 |
Tzou [40] | 2017 | USA, Japan | OS, co, MC | 1174 | 12 |
Baseline characteristics
Number of studies | Image-guided | Non-image-guided | p-value | ||
---|---|---|---|---|---|
Age | 38 | 64 | 66 | 0.07 | |
EF | 38 | 34 | 32 | 0.09 | |
(%) | (%) | ||||
Male | 36 | 94 | 90 | 0.40 | |
Infarct location | Anterior | 21 | 43 | 40 | 0.80 |
Inferoposterior | 20 | 52 | 46 | 0.66 | |
NYHA class III + IV | 18 | 11 | 34 | 0.07 | |
Electric storm | 23 | 49 | 36 | 0.45 | |
Diabetes mellitus | 22 | 19 | 30 | 0.13 | |
Hypertension | 27 | 70 | 60 | 0.11 | |
Amiodarone therapy | 34 | 68 | 54 | 0.41 | |
Prior VT ablation | 23 | 32 | 15 | 0.14 | |
Epicardial access | 34 | 37 | 6 | <0.01 | |
ICD carrier | 31 | 55 | 94 | 0.02 | |
(min) | (min) | ||||
Procedural duration | 28 | 269 [250–] | 220 [194–265] | 0.09 | |
Radiofrequency time | 13 | 34 [32–] | 38 [24–67] | 0.93 | |
Radiation exposure | 24 | 54 [34–] | 28 [15–38] | 0.18 |