Comparative evaluation of the results of a prospective registry of high power radiofrequency ablation of ventricular arrhythmias in ischemic patients

The results of ventricular tachycardia (VT) ablation in patients with structural heart disease are not optimal. Our previous study demonstrated that the use of high-energy radiofrequency ablation (RFA) in ischemic patients has a good long-term beneficial effect. This study is a randomized comparison of the efficacy of high power RFA with standard RFA power characteristics. Aim: is to compare the results of treatment of ventricular tachycardias in ischemic patients with high power RFCA (50 W) and standard RFCA (45 W) in a multicenter prospective registry. Methods: The study included 119 patients (59% men) with ischemic heart disease and drug-resistant VT who were referred for RFA. The patients were randomly divided into two groups. In the first group, the ablation procedure was performed with 50 W RF energy (high power RFA), in the second group, with 45 W (standard RFA). Non-fluoroscopic 3D navigation systems were used for bipolar and activation mapping with standard settings. The safety endpoint included perioperative complications such as death, hemopericardium, stroke, myocardial infarction, electrical storm, and vascular complications. The efficacy endpoint is VT inducibility at the end of the ablation procedure and no VT at 12 months of follow-up. Primary secondary endpoints: change in implanted cardiovector-defibrillator (ICD) therapy, ultrasound scores, and number of hospitalizations. Results. All patients underwent VT ablation under general sedation. Before the ablation procedure, at least 1 clinical VT was induced in 96,8% of patients in the high-power RFA group and 92,9% in patients in the standard RFA group. After ablation, clinical VT was not induced (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }