Real-time Automated Program for IDentification of VT Origin (RAPIDVTPilot)
Ventricular Tachycardia, Ischemic Heart Disease
About this trial
This is an interventional treatment trial for Ventricular Tachycardia focused on measuring Catheter ablation, ECG imaging
Eligibility Criteria
Inclusion Criteria:
Patients will be eligible for inclusion if they fulfilled VANISH inclusion criteria by having both of:
- Prior myocardial infarction (pathological Q waves or imaging evidence of regional myocardial akinesis/thinning in the absence of a non-ischemic cause)38 and
- One of the following VT events within the last 6 months while on Amiodarone or another class III or class I antiarrhythmic drug:
A: Sustained monomorphic VT documented on 12-lead ECG or rhythm strip requiring termination by pharmacologic means or DC cardioversion, B: ≥3 episodes of symptomatic VT treated with anti-tachycardia pacing (ATP), C: ≥1 appropriate ICD shocks, D: ≥3 VT episodes within 24 hours, separated by ≥ 5 minutes, E: sustained VT below detection rate of an ICD
Exclusion Criteria:
Patients will be excluded from the trial if they:
- Are unable or unwilling to provide informed consent.
- Have active ischemia or another reversible cause of VT (e.g. drug-induced arrhythmia), or had recent acute coronary syndrome requiring revascularization.
- Are antiarrhythmic drug-naïve.
- Are known to have protruding left ventricular thrombus or mechanical aortic and mitral valves.
- Have had a prior catheter ablation procedure for VT.
- Are in renal failure (Creatinine clearance <15 mL/min)
- Have NYHA Functional class IV heart failure or CCS Functional class IV angina.
- Have had recent ST elevation myocardial infarction (< 1 month).
- Are pregnant or have a systemic illness likely to limit survival to <1 year.
Sites / Locations
- QE II Health Sciences Centre
Arms of the Study
Arm 1
Experimental
RAPID-VT Software guided ablation
The induced VT(s) 12-lead ECG will be acquired by the RAPID-VT software which will provide real time localization of the VT(s) exits from the scar margin. These exits will be targeted by ablation