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Safety and effectiveness of intracardiac echocardiography in ventricular tachycardia ablation: a nationwide observational study

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Abstract

Intracardiac echocardiography (ICE) utilized in conjunction with three-dimensional (3-D) mapping systems could enhance ventricular tachycardia (VT) ablation procedures. ICE has been increasingly used in VT ablation; however, the safety and effectiveness of VT ablation under the combined use of ICE remains unclear. The present study aimed to analyze the safety and short-term effects of VT ablation with or without ICE. We retrospectively enrolled patients who underwent initial VT ablation with a combination of ICE and a 3-D mapping system within 3 days of hospitalization and discharged from April 2011 to March 2017 using a nationwide Japanese inpatient database. Following enrollment, we conducted a propensity score-matching analysis to compare safety (in-hospital complications) and effectiveness (readmission within 30 days after discharge due to cardiovascular disease and readmissions within 30 days for repeat VT ablations) between patients who underwent VT ablation with (ICE group) and without ICE (non-ICE group). 3-D mapping systems were applied to both groups. We identified 5,804 eligible patients (1,272 and 4,532 patients in the ICE and non-ICE groups, respectively). One-to-one propensity score matching created a total of 1,147 pairs between the ICE and non-ICE groups. The ICE group showed a significantly lower prevalence of cardiac tamponade than the non-ICE group. There were no significant differences observed between the two groups regarding other outcomes concerning safety and effectiveness. Ventricular tachycardia ablation with ICE used in combination with a 3-D mapping system may reduce cardiac tamponade; however, no additional clinical advantages were noted in terms of safety and effectiveness.

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Funding

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (19AA2007 and 20AA2005) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (20H03907).

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Authors and Affiliations

  1. Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo, Japan

    Takeshi Kitamura, Iwanari Kawamura & Seiji Fukamizu

  2. Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan

    Mikio Nakajima & Richard H. Kaszynski

  3. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan

    Mikio Nakajima, Hiroyuki Ohbe, Hiroki Matsui & Hideo Yasunaga

  4. Data Science Center, Jichi Medical University, Tochigi, Japan

    Yusuke Sasabuchi

  5. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan

    Kiyohide Fushimi

Authors
  1. Takeshi Kitamura
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  2. Mikio Nakajima
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  3. Iwanari Kawamura
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  4. Richard H. Kaszynski
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  5. Hiroyuki Ohbe
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  6. Yusuke Sasabuchi
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  7. Hiroki Matsui
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  8. Kiyohide Fushimi
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  9. Seiji Fukamizu
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  10. Hideo Yasunaga
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Contributions

All authors contributed to the study conception and design meeting three criteria: [1] substantial contributions to research design, or the acquisition, analysis or interpretation of data; [2] drafting the paper or revising it critically; [3] approval of the submitted and final versions. Material preparation, data collection and analysis were performed by [TK, MN, IK, HO, YS, HM, KF and HY]. The first draft of the manuscript was written by [TK, MN, IK, RK, HO, YS, SF and HY] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Takeshi Kitamura.

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Kitamura, T., Nakajima, M., Kawamura, I. et al. Safety and effectiveness of intracardiac echocardiography in ventricular tachycardia ablation: a nationwide observational study. Heart Vessels 36, 1009–1015 (2021). https://doi.org/10.1007/s00380-020-01766-y

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  • DOI: https://doi.org/10.1007/s00380-020-01766-y

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