Ripple Mapping Guided Ablation of Ischaemic Ventricular Tachycardia.

Launched by IMPERIAL COLLEGE HEALTHCARE NHS TRUST · Jun 24, 2019

Keywords

ClinConnect Summary

Patients who have ischaemic heart disease and are at sufficient risk of, or have suffered, ventricular tachycardia may receive implantable cardioverter defibrillator (ICD) devices. ICD devices provide life-saving shocks to terminate ventricular tachycardia. There is however substantial evidence that correlates each life-saving shock with worsening prognosis.

Catheter ablation is a procedure that can treat the cause of ischaemic ventricular tachycardia (VT). Most catheter ablation procedures for ischaemic VT are performed in normal rhythm, with an end-point of arrhythmic substrate modificat...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Patients with coronary artery disease and ischaemic cardiomyopathy requiring ICD implantation for primary or secondary prevention.
• • 2. Any episode of VT detected or treated appropriately (within monitor zone or therapy (ATP/shock) delivered) or by 12 lead ECG if the rate below the detection level of the device. An episode of VT will be defined as lasting more than 30 secs or a regular high rate episode meeting VT criterion for \>50% of the time before the first therapy is delivered (i.e. VT degenerating into VF is acceptable under these circumstances).
• • 3. Ablation or medical therapy would be considered reasonable option for ongoing management.
• • 4. Males or females 18 - 80 years of age.
• • 5. Suitable candidate for catheter ablation.
• • 6. Signed informed consent.
• Exclusion Criteria:
• • 1. Contraindication to catheter ablation.
• • 2. VT due to reversible causes.
• • 3. Severe valvular disease or ventricular thrombus.
• • 4. Active gastrointestinal bleeding.
• • 5. Serum Creatinine \>200μmol/L or on dialysis.
• • 6. Active fever or infection.
• • 7. Life expectancy shorter than the duration of the trial.
• • 8. Allergy to contrast.
• • 9. Intractable heart failure (NYHA Class IV).
• • 10. Bleeding or clotting disorders or inability to receive heparin.
• • 11. Malignancy needing surgery, chemotherapy or radiotherapy.
• • 12. Pregnancy or women of child-bearing potential not using a highly effective method of contraception.
• • 13. Unable to attend follow-up visits or ICD clinics.