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Predictors of VT recurrence in patients with VT inducibility at the end of radiofrequency ablation: Should we use VT non-inducibility as a routine endpoint?
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  • Kazutaka Nakasone,
  • Koji Fukuzawa,
  • Kunihiko Kiuchi,
  • Mitsuru Takami,
  • jun sakai,
  • Toshihiro Nakamura,
  • atsusuke yatomi,
  • Yusuke Sonoda,
  • Hiroyuki Takahara,
  • Kyoko Yamamoto,
  • Yuya Suzuki,
  • Kenichi Tani,
  • Hidehiro Iwai,
  • Yusuke Nakanishi,
  • Ken-ichi Hirata
Kazutaka Nakasone
Kobe University Graduate School of Medicine
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Koji Fukuzawa
Kobe University Graduate School of Medicine
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Kunihiko Kiuchi
Kobe University Graduate School of Medicine
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Mitsuru Takami
Kobe University Graduate School of Medicine
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jun sakai
Kobe University Graduate School of Medicine
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Toshihiro Nakamura
Kobe University
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atsusuke yatomi
Kobe University Graduate School of Medicine
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Yusuke Sonoda
Kobe University Graduate School of Medicine
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Hiroyuki Takahara
Kobe University Graduate School of Medicine
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Kyoko Yamamoto
Kobe University Graduate School of Medicine
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Yuya Suzuki
Akashi Medical Center
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Kenichi Tani
Kobe University Hospital
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Hidehiro Iwai
Kobe University Graduate School of Medicine
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Yusuke Nakanishi
Kobe University Graduate School of Medicine
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Ken-ichi Hirata
Kobe University Graduate School of Medicine
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Abstract

Introduction: It has been reported that ventricular tachycardia (VT) non-inducibility at the end of ablation is associated with less likely VT recurrence. However, it is not clear whether we should use VT non-inducibility as routine end point in VT ablation. The aim of this study was to evaluate VT recurrence in patients in whom VT non-inducibility could not be achieved at the end of the RF ablation and the factors attributing to the VT recurrence. METHODS and RESULTS: We analyzed 84 consecutive patients that underwent RF ablation, and 64 patients in whom VT non-inducibility could not be achieved were studied. The primary endpoint was recurrence of any sustained VT during the follow-up. During a median follow-up period of 1.4 years (IQR:0.3-2.0), 22 (34%) of the cases had VT recurrences. In the multivariate analysis showed that an LVEF≥35% (HR:0.21; 95% CI:0.07- 0.54; P<0.01) and successful identification and ablation of all clinical VT isthmuses (HR:0.21; 95% CI:0.03- 0.72; P=0.01) were independent predictors of fewer VT recurrences. RF ablation was associated with a 91.1% reduction in VT episodes. CONCLUSION: Even if VT non-inducibility could not be achieved, the patients with LVEF≥35% or in whom all clinical VT isthmuses could successfully be identify and ablated might be prevented from having VT recurrences. The validity of VT non-inducibility of any VT should be evaluated by each patient’s background and the results of the procedure.