{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T20:31:33Z","timestamp":1780518693532,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T00:00:00Z","timestamp":1532304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Multiple ablations are often necessary to manage ventricular arrhythmias (VAs) in nonischemic cardiomyopathy (NICM) patients. We assessed characteristics and outcomes and role of adjunctive, nonstandard ablation in repeat VA ablation (RAbl) in NICM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Consecutive NICM patients undergoing RAbl were analyzed, with characteristics of the last VA ablations compared between those undergoing 1 versus multiple\u2010repeat ablations (1\u2010RAbl vs.\u00a0&gt;1RAbl), and between those with or without midmyocardial substrate (MMS). VA\u2010free survival was compared. Eighty\u2010eight patients underwent 124 RAbl, 26 with\u00a0&gt;\u00a01RAbl, and 26 with MMS. 1\u2010RAbl and\u00a0&gt;\u00a01\u2010RAbl groups were similar in age (57 \u00b1 16\u00a0vs. 57 \u00b1 17 years; <jats:italic>P\u00a0<\/jats:italic>=\u00a00.92), males (76%\u00a0vs. 69%; <jats:italic>P<\/jats:italic> = 0.60), LVEF (40 \u00b1 17%\u00a0vs. 40 \u00b1 18%; <jats:italic>P<\/jats:italic> = 0.96), and amiodarone use (31%\u00a0vs. 46%, <jats:italic>P<\/jats:italic> = 0.22). One\u2010year VA freedom between 1\u2010RAbl vs.\u00a0&gt;\u00a01RAbl was similar (82%\u00a0vs. 80%; <jats:italic>P<\/jats:italic> = 0.81); adjunctive ablation was utilized more in\u00a0&gt;1RAbl (31%\u00a0vs. 11%, <jats:italic>P<\/jats:italic> = 0.02), and complication rates were higher (27%\u00a0vs. 7%, <jats:italic>P<\/jats:italic> = 0.01), most due to septal substrate and anticipated heart block.\u00a0&gt;1\u2010RAbl patients had more MMS (62%\u00a0vs. 16%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Although MMS was associated with worse VA\u2010free survival after 1\u2010RAbl (43%\u00a0vs. 69%, <jats:italic>P<\/jats:italic> = 0.01), when\u00a0&gt;1RAbl was performed, more often with nonstandard ablation, VA\u2010free survival was comparable to non\u2010MMS patients (85%\u00a0vs. 81%; <jats:italic>P<\/jats:italic> = 0.69). More RAbls were required in MMS versus non\u2010MMS patients (2.00 \u00b1 0.98\u00a0vs. 1.16 \u00b1 0.37; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For NICM patients with recurrent, refractory VAs despite previous ablation, effective arrhythmia control can safely be achieved with subsequent ablation, although\u00a0&gt;1 repeat procedure with adjunctive ablation is often required, especially with MMS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13663","type":"journal-article","created":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T08:19:46Z","timestamp":1532333986000},"page":"1403-1412","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Repeat ablation of refractory ventricular arrhythmias in patients with nonischemic cardiomyopathy: Impact of midmyocardial substrate and role of adjunctive ablation 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