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Abstract
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Scar-related ventricular tachycardia ablation using a dual-energy lattice-tip ablation system guided by pre-procedural imaging
Session:
Sessão de Posters 37 - Estratégias avançadas em arritmias ventriculares e ablação
Speaker:
Daniel Inácio Cazeiro
Congress:
CPC 2026
Topic:
C. Arrhythmias and Device Therapy
Theme:
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
Subtheme:
08.4 Ventricular Arrhythmias and SCD - Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Daniel Inácio Cazeiro; Joana Brito; Diogo Ferreira; Marta Vilela; Afonso Nunes Ferreira; Catarina Almeida Barreiros; Joana Quaresma; Sónia Teixeira; Gustavo Lima da Silva; João de Sousa; Fausto J. Pinto; Nuno Cortez-Dias
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Introduction: </strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000">Catheter ablation for scar-related ventricular tachycardia (VT) remains challenging due to limitations in ventricular mapping and the need for deeper lesions to eliminate intramural conduction channels.</span></span></span></p> <p> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Aim</strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000">: To evaluate the feasibility, safety, and acute efficacy of a structured multimodal planning strategy combined with a hybrid high-energy ablation protocol for scar-related VT.</span></span></span></p> <p> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Methods</strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000">: We prospectively studied consecutive patients undergoing endocardial VT ablation guided by pre-procedural imaging integration. Multidetector computed tomography (MDCT) and late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) were segmented and co-registered into the mapping system to prioritize zones of interest. A standardized hybrid protocol—radiofrequency followed by pulsed-field ablation at each site—was applied. Acute success was defined as complete elimination of local abnormal ventricular activity (LAVA) and VT non-inducibility.</span></span></span></p> <p> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Results</strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000">: Nineteen patients (mean age 68 ± 8 years; 74% ischemic cardiomyopathy; 63% VT storm) were included. Imaging predicted LAVA-bearing segments with sensitivity/specificity of 80%/85% for MDCT and 67%/75% for LGE-CMR. Complete LAVA abolition was achieved in 94.7% of patients, and VT non-inducibility in 73.7%. One major vascular complication occurred; no deaths or cardiac perforations were observed. After a median follow-up of 106 days, VT recurrence occurred in 10.5% of patients.</span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong> </strong></span></span></span></p> <p> </p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000"><strong>Conclusion: </strong></span></span></span><span style="font-size:12pt"><span style="font-family:'Times New Roman',serif"><span style="color:#000000">A structured imaging-guided workflow combined with hybrid RF–PFA ablation is feasible and safe, achieving high acute success in scar-related VT. Further studies should confirm long-term outcomes and optimize energy delivery parameters.</span></span></span></p>
Slides
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