- Al-Khatib S.M.
- Stevenson W.G.
- Ackerman M.J.
- Bryant W.J.
- Callans D.J.
- Curtis A.B.
- et al.
- 1.Identification of ICM and NICM patients, that had received radiofrequency catheter ablation (RFA) for the management/treatment of ventricular tachycardia;
- 2.Reported acute procedural success;
- 3.Reported ventricular arrhythmia recurrence at follow-up.
Patient and Public Involvement
Data Extraction and Critical Appraisal
|ICM (n=4,418)||NICM (n=3,055)||P-value|
|Mean age (years)||67.0±10.8||55.3±14.6||<0.001|
|Male gender (%)||2,638/2,977 (89)||1,449/1827 (79)||<0.001|
|Left ventricular ejection fraction||29.3±11.8||38.2±16.5||<0.001|
|AICD in situ (%)||2,305/2,479 (89)||1,354/1538 (85)||<0.001|
|No. of inducible VTs||2.6±1.7||2.4±1.7||<0.001|
|Cycle length of inducible VTs||391±98.6||379±91.7||0.044|
|Epicardial access||356/3,128 (11)||681/1,869 (36)||<0.001|
|Haemodynamic support required||17.4% (95% CI 7.4–35.9)||13.9% (95% CI 3.7–40.4)||0.04|
|Outcome||Cohort||Pooled Incidence (95% CI)||Meta-Analysis of ICM vs NICM||Meta-Regression|
|RR (95% CI)||P-value||Coefficient (95% CI)||P-value|
|Acute Procedural Success||ICM||66.6% (61.5–71.4)||1.10 (1.05–1.15)||<0.001||-0.02 (-0.06–0.03)||0.40|
|NICM||56.6% (51.6–61.4)||-0.02 (-0.06–0.03)||0.42|
|Peri-Procedural Mortality||ICM||3.5% (2.7–4.4)||1.07 (0.73–1.57)||0.73||-0.007 (-0.08–0.07)||0.85|
|NICM||4.2% (2.7–6.5)||-0.02 (-0.13–0.09)||0.70|
|Peri-Procedural Complications||ICM||10.0% (7.7–12.9)||1.09 (0.85–1.40)||0.48||-0.009 (-0.07–0.05)||0.77|
|NICM||9.3% (7.2–11.9)||0.03 (-0.03–0.09)||0.33|
|VT Recurrence at Follow-Up||ICM||18.7/100 patient years (15.0–22.4)||0.77 (0.70–0.84)||<0.001||0.005 (-0.002–0.01)||0.16|
|NICM||26.3/100 patient years (21.3–31.3)||0.004 (-0.007–0.02)||0.48|
|Mortality at Follow-Up||ICM||10.1/100 patient years (7.6–12.7)||1.03 (0.81–1.33)||0.79||0.001 (-0.003–0.006)||0.58|
|NICM||8.6/100 patient years (5.9–11.2)||0.004 (0.001–0.008)||0.008|
Peri-Procedural Mortality and Morbidity
- 1)ICM and NICM patients at baseline characteristics are uniquely distinct from one another. Patients with ICM were more likely to be male, older and have greater left ventricular ejection fraction (LVEF) impairment than patients with NICM.
- 2)Acute procedural success was lower in NICM patients, despite longer procedural times, longer fluoroscopy times and higher rates of epicardial access. In contrast, ICM patients had longer RF ablation times and were more likely to require haemodynamic support.
- 3)Ventricular arrhythmia recurrence post-ablation is greater in NICM patients compared to ICM patients, however peri-procedural long-term mortality did not statistically favour one specific aetiology.
- 4)Meta-regression analysis showed no significant change over time in the incidence of VA recurrence at follow-up. Long-term mortality rates were not significantly moderated by publication year for ICM cohort but a marginal increase in mortality was seen in more recent publications for patients with NICM.
Fundamental Differences in the Demographic Profile Between ICM and NICM
Differences in Procedural Characteristics Between the ICM and NICM Patients
- Kumar S.
- Fujii A.
- Kapur S.
- Romero J.
- Mehta N.K.
- Tanigawa S.
- et al.
Differences in Acute Procedural Success and Outcomes in ICM vs NICM Patients
Trends in Outcomes on Meta-Regression Analysis
- Supplement Table 1-3
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