Ablation strategies for arrhythmogenic right ventricular cardiomyopathy: a systematic review and meta-analysis.
Lishui Shen, Limin Liu, Lihui Zheng, Feng Hu, Zhicheng Hu, Shangyu Liu, Jinrui Guo, Kush Kumar Bhagat, Yan Yao
Abstract
BACKGROUND: Catheter ablation for ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) has significantly evolved over the past decade. However, different ablation strategies showed inconsistency in acute and long-term outcomes. METHODS: We searched the databases of Medline, Embase and Cochrane Library through October 17, 2019 for studies describing the clinical outcomes of VT ablation in ARVC. Data including VT recurrence, all-cause mortality, acute procedural efficacy and major procedural complications were extracted. A meta-analysis with trial sequential analysis was further performed in comparative studies of endo-epicardial versus endocardial-only ablation. RESULTS: = 0.90). CONCLUSION: Catheter ablation for VT in ARVC is feasible and effective. Epicardial ablation is associated with better long-term VT freedom, but with more major complications and unremarkable survival or acute efficacy benefit.