About this trial
Over the last decade, radiofrequency catheter ablation (RFCA) has become an established treatment for ventricular arrhythmias (VA). Due to the challenging nature of visualizing lesion formation in real time and ensuring an effective transmural lesion, different surrogate measures of lesion quality have been used. The Ablation Index (AI) is a variable incorporating power delivery in its formula and combining it with CF and time in a weighted equation which aims at allowing for a more precise estimation of lesion depth and quality when ablating VAs. AI guidance has previously been shown to improve outcomes in atrial and ventricular ablation in patients with premature ventricular complexes (PVC). However research on outcomes following AI-guidance for VT ablation specifically in patients with structural disease and prior myocardial infarction remains sparse. The investigators aim at conducting the first randomized controlled trial testing for the superiority of an AI-guided approach regarding procedural duration.
Eligibility criteria
Qualifiers
Patient ≥ 18 y.o.
Structural Heart Disease: Ischemic Cardiomyopathy
Sustained Scar-related Monomorphic Ventricular Tachycardia documented by ECG or CIED interrogation
Disqualifiers
If clinical ventricular arrhythmia is predominantly PVCs, supraventricular tachycardia, or ventricular fibrillation
Myocardial infarction or cardiac surgery within 6 months
Severe mitral regurgitation
Stroke or TIA within 6 months
Trial design
Treatments tested in this trial
- Ablation-index guided ventricular tachycardia ablation
- Ventricular tachycardia ablation with no AI-guidance
Treatment groups
Sponsors and collaborators
Rush University Medical Center
Lead sponsor
University of Michigan
Collaborator
Medical University of South Carolina
Collaborator
Biosense Webster, Inc.
Collaborator
Mayo Clinic
Collaborator
Brigham and Women's Hospital
Collaborator