SMART Identification of Ventricular Tachycardia Isthmus

NCT ID: NCT04852497

Last Updated: 2023-08-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-04-01

Study Completion Date

2024-09-01

Brief Summary

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Context :

Ventricular tachycardia (VT) are serious heart rhythm disorders which can lead to sudden death. A curative treatment for these abnormalities in the cardiac electrical conduction system is possible through an interventional electrophysiology procedure. A catheter is inserted, generally via a femoral access, and is introduced in the heart ventricles in order to collect various 3D electro-anatomical maps.

The pace-mapping technique developed in Nancy (de Chillou et al, Heart Rhythm 2014) allows the reentrant circuit underlying the VT to be identified, as well as a definition of the target zones to be ablated, using radiofrequency energy with the catheter. The pace-mapping technique consists of stimulating the ventricle from various sites within its internal surface, in order to generate different activation pathways of the myocardium. When an activation pathway is similar to the VT pathway, this means that the stimulation site is located near the pathologic zone to be ablated. The surface electrocardiogram (ECG) is used to compare activation pathways. A 3D correlation ma is then generated: the zones with high correlation (\>90%) indicated the exit of the reentrant circuit, while rapid transition zones (several %/mm) indicate the entrance of the VT circuit. The pace-mapping technique has several limitations: (i) it requires an ECG recording of the clinical VT of the patient (spontaneous or induced at the beginning of the procedure), however it is not always possible to induce it; (ii) sometimes several VT circuits may be present, rendering the procedure of identification and ablation non-exhaustive.

The aim of this study is to analyze retrospectively electroanatomical data collected during the intervention, in order to develop a new method for identifying target zones to be ablated, and to compare the results with the conventionally used method.

Hypothesis :

The investigators hypothesize that alternative methods to analyze electroanatomical data (surface ECG and spatial coordinates of the pacing sites) could provide information equivalent to conventional methods (e.g. VT correlation map, VT activation maps etc…) without the need for a reference recording of the clinical VT of the patient.

Detailed Description

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Conditions

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Ventricular Tachycardia Ischemic Cardiomyopathy

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Interventions

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Ventricular tachycardia ablation

patients having undergone ventricular tachycardia radiofrequency ablation using of pace mapping strategy to identify the critical isthmus

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Ventricular tachycardia ablation between October 2014 and April 2021
* Patient for whom electroanatomical data are available.
* Ischemic cardiomyopathy / previous myocardial infarction
* At least 30 points of pace-mapping during the VT procedure

Exclusion Criteria

* Incomplete data
* Poor quality ECG recordings
* Absence of ventricular tachycardia isthmus identified during the procedure
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Central Hospital, Nancy, France

OTHER

Sponsor Role lead

Responsible Party

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Christian DE CHILLOU

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University Hospital of Nancy

Vandœuvre-lès-Nancy, , France

Site Status RECRUITING

Countries

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France

Facility Contacts

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Christian De Chillou, MD, PhD

Role: primary

+33383157443

Other Identifiers

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2018-110

Identifier Type: -

Identifier Source: org_study_id

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