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Follow‐up after hemodynamically not tolerated ventricular tachycardia in patients with midrange reduced to normal ejection fraction: A retrospective single‐centre case series
Author(s) -
Groeneveld Sanne A.,
Blom Lennart J.,
Heijden Jeroen F.,
Loh Peter,
Hassink Rutger J.
Publication year - 2021
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13359
Subject(s) - ejection fraction , medicine , cardiology , ventricular tachycardia , retrospective cohort study , hemodynamics , implantable cardioverter defibrillator , prospective cohort study , tachycardia , electrophysiology study , radiofrequency ablation , catheter ablation , ablation , heart failure
The benefit of implantable cardioverter‐defibrillator (ICD) implantation in patients with hemodynamically not tolerated ventricular tachycardia (VT) and midrange reduced to normal ejection fraction (LVEF >35%) is currently unclear. The purpose of this study was to investigate follow‐up after hemodynamically not tolerated VT in patients with LVEF >35%. In addition, we aimed to find possible predictive factors to identify who will benefit from ICD implantation. Methods In a retrospective single‐centre case series, all patients with hemodynamically not tolerated VT and LVEF >35% that underwent electrophysiological study (EPS) and/or radiofrequency VT ablation were included. Results Forty‐two patients (5 women, median age 68 years) with hemodynamically not tolerated VT and LVEF >35% underwent EPS. VT ablation was performed in thirty‐one patients, which was considered successful in twenty‐three patients. Nineteen patients had an ICD at discharge while 23 patients were discharged without an ICD. The severity of hemodynamic compromise, LVEF and ablation success played an important role in the decision‐making for ICD implantation. Six patients (14.3%) had recurrence of VT, all hemodynamically tolerated. Conclusions In this small case series, patients with hemodynamically not tolerated VT and LVEF >35% had a relatively low recurrence rate and all recurrences were nonfatal. Based on our results, we hypothesize that the severity of hemodynamic compromise, LVEF and ablation success might modify the risk for VA recurrence. A prospective study to determine the prognostic value of these factors in patients with hemodynamically not tolerated VT and LVEF >35% is necessary.