title: Contact versus noncontact mapping for ablation of ventricular tachycardia in patients with previous myocardial infarction.
abstract: BACKGROUND
  The aim of this study was to compare contact versus noncontact mapping for radiofrequency (RF) ablation of any sustained post-myocardial infarction (MI) ventricular tachycardia (VT).
  
  
  METHODS
  Forty patients with tolerated VT post-MI were randomized to RF ablation with contact (group 1) or noncontact (group 2) mapping systems. In both groups ablation of tolerated VT was guided by VT activation map confirmed by concealed entrainment. When untolerated VTs were induced, ablation was performed in group 1 according to pace mapping starting from the scar border zone and in group 2 according to the VT activation map confirmed by pace mapping.
  
  
  RESULTS
  No differences were seen between the groups in terms of acute success rate of clinical VT ablation (95% vs 100%, respectively; P = ns) and in the noninducibility of any VT at the end of the procedure (55% vs 85%, respectively; P = 0.08). Moreover, untolerated VTs were eliminated in 30% of group 1 versus 83.3% of group 2 patients (P < 0.05). The mean total procedural and fluoroscopy times were 236.4 +/- 42.7 and 29.0 +/- 7.8 minutes in group 1 and 144.5 +/- 50.8 and 23.4 +/- 5.8 minutes in group 2 (P < 0.001 and < 0.05, respectively). At a mean follow-up of 15.2 +/- 6.7 months no differences were seen in VT recurrences between groups, but noninducibility at the end of the procedure was predictive of freedom from recurrences (P < 0.001).
  
  
  CONCLUSIONS
  Both systems are useful for ablation of tolerated VT. Noncontact mapping is more effective for ablation of untolerated VT and allows the reduction of procedural and fluoroscopy times. Noninducibility at the end of the procedure seems predictive of freedom from recurrences during follow-up.
authors: Chair of Cardiology, S. Anna University Hospital, Ferrara, Italy. ltt@unife.it
authors: Claudio
authors: C
authors: Pratola
authors: Elisa
authors: E
authors: Baldo
authors: Tiziano
authors: T
authors: Toselli
authors: Pasquale
authors: P
authors: Notarstefano
authors: Paolo
authors: P
authors: Artale
authors: Artale
authors: A
authors: Paolo
authors: Roberto
authors: R
authors: Ferrari
mesh_terms: D000368:Aged; D018780:Body Surface Potential Mapping / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome