title: Long-Term Success of Irrigated Radiofrequency Catheter Ablation of Sustained Ventricular Tachycardia: Post-Approval THERMOCOOL VT Trial.
abstract: BACKGROUND
  Radiofrequency catheter ablation is used to treat recurrent ventricular tachycardia (VT).
  
  
  OBJECTIVE
  This study evaluated long-term safety and effectiveness of radiofrequency catheter ablation using an open-irrigated catheter.
  
  
  METHODS
  Patients with sustained monomorphic ventricular tachycardia associated with coronary disease were analyzed for cardiovascular-specific adverse events within 7 days of treatment, hospitalization duration, 6-month sustained monomorphic ventricular tachycardia recurrence, quality of life measured by the Hospital Anxiety and Depression Scale, long-term (1-, 2-, and 3-year) survival, symptomatic VT control, and amiodarone use.
  
  
  RESULTS
  Overall, 249 patients, mean age 67.4 years, were enrolled. The cardiovascular-specific adverse events rate was 3.9% (9 of 233) with no strokes. Noninducibility of targeted VT was achieved in 75.9% of patients. Post-ablation median hospitalization was 2 days. At 6 months, 62.0% (114 of 184) of patients had no sustained monomorphic ventricular tachycardia recurrence; the proportion of patients with implantable cardioverter-defibrillator shocks decreased from 81.2% to 26.8% (p < 0.0001); the frequency of VT in implantable cardioverter-defibrillator patients with recurrences was reduced by ≥50% in 63.8% of patients; and the proportion with normal Hospital Anxiety and Depression Scale scores increased from 48.8% to 69.1% (p < 0.001). Patient-reported VT remained steady for 1, 2, and 3 years at 22.7%, 29.8%, and 24.1%, respectively. Amiodarone use and hospitalization decreased from 55% and 77.2% pre-ablation to 23.3% and 30.7%, 18.5% and 36.7%, 17.7% and 31.3% at 1, 2, and 3 years, respectively.
  
  
  CONCLUSIONS
  Radiofrequency catheter ablation reduced implantable cardioverter-defibrillator shocks and VT episodes and improved quality of life at 6 months. A steady 3-year nonrecurrence rate with reduced amiodarone use and hospitalizations indicate improved long-term outcomes. (NaviStar ThermoCool Catheter for Endocardial RF Ablation in Patients With Ventricular Tachycardia [THERMOCOOL VT]; NCT00412607).
authors: Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: francis.marchlinski@uphs.upenn.edu.
authors: Francis E
authors: FE
authors: Marchlinski
authors: Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors: Charles I
authors: CI
authors: Haffajee
authors: Division of Cardiovascular Diseases, Mayo Clinic Foundation, Phoenix, Arizona.
authors: John F
authors: JF
authors: Beshai
authors: Division of Cardiology, School of Medicine, University of Maryland, Baltimore, Maryland.
authors: Timm-Michael L
authors: TL
authors: Dickfeld
authors: Penn State Heart and Vascular Institute, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania.
authors: Mario D
authors: MD
authors: Gonzalez
authors: Cardiology Department, San Francisco Veterans Affairs Medical Center, University of California San Francisco, California.
authors: Henry H
authors: HH
authors: Hsia
authors: Division of Cardiology, Henry Ford Hospital, Detroit, Michigan.
authors: Claudio D
authors: CD
authors: Schuger
authors: Heart Rhythm Institute, University of Oklahoma, Oklahoma City, Oklahoma.
authors: Karen J
authors: KJ
authors: Beckman
authors: Division of Cardiology, University of Michigan Health System, Ann Arbor, Michigan.
authors: Frank M
authors: FM
authors: Bogun
authors: Cardiovascular Institute, Florida Hospital, Orlando, Florida.
authors: Scott J
authors: SJ
authors: Pollak
authors: Los Angeles Cardiology Associates, Los Angeles, California.
authors: Anil K
authors: AK
authors: Bhandari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D018795:Device Approval; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*; D007507:Therapeutic Irrigation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
keywords: ThermoCool; catheter ablation; quality of life; radiofrequency; safety; ventricular tachycardia