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Title: Catheter ablation for ventricular tachycardia in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy: a systematic review and meta-analysis
Author(s): H. Jiang , X.-L. Zhang , Q.-L. Yang , S.-H. Zhu , H.-S. Yu , B. Xu , W. Huang
Journal: Acta Cardiologica
Volume: 71 Issue: 6 Date: 2016
Objective: Catheter ablation is commonly performed for ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). The success rate of VT ablation, either conventional endocardial strategy or recent combined endocardial and epicardial approach, in ARVD/C patients still remains to be determined because of the relatively small sample sizes and various outcomes of previous studies.
Methods: PubMed, EMBASE and Cochrane Library were comprehensively searched from their inception until September 2015. All studies have to report acute and long-term efficacy of VT ablation in ARVD/C patients. Data was extracted and analysed according to pre-defined criterions.
Results: Eight eligible studies were identified. The mean follow-up duration ranged from 13 to 41 months (median 20 months). The acute efficacy of VT ablation in ARVD/C patients was high, regardless of the ablation strategy. Pooled estimate of acute efficacy was 96% (95% CI: 87%-100%) for endocardial ablation strategy and 98% (95% CI: 91%-100%) for endo-epicardial ablation strategy. Pooled estimate for long-term efficacy with endo-epicardial ablation strategy (82%, 95% CI: 72%-90%) was numerically higher than individual endocardial ablation strategy (63%, 95% CI: 51%-74%).
Conclusions: The current evidence suggests that VT ablation in ARVD/C patients is feasible with a high acute and long-term efficacy. Combined endocardial and epicardial ablation strategy is associated with a numerically better outcome of long-term efficacy than individual endocardial ablation strategy.