Arrhythmogenic Substrate in Primary Cardiomyopathies
Arrhythmogenic Substrate in Primary Cardiomyopathies
This study assesses the value of arrhythmogenic substrate identification and elimination by
 catheter ablation to prevent recurrent ventricular arrhythmias and sudden cardiac death in a
 series of selected patients with primary cardiomyopathy and ICD implantation.
The present study is designed as a prospective single center study. All selected patients
 with implanted ICD to prevent VT/VF recurrence who are referred to the Arrhythmology
 Department of San Donato Milanese Hospital, for the management of a primary cardiomyopathy
 fulfilling the inclusion criteria will be enrolled. Primary cardiomyopathies include: -
 dilated cardiomyopathy (DCM), - arrhythmogenic right ventricular cardiomyopathy (ARVC), -
 left ventricular non-compaction (LVNC), - early repolarization syndrome (ER), and -
 hypertrophic cardiomyopathy (HCM). Patients with a family history of BrS, will also be
 included. Endo-epicardial electroanatomical 3Dmapping and RFA ablation will be systematically
 performed according to a standardized procedure. Patients will be monitored for at least 3
 days after RF ablation. Before hospital discharge, echocardiography and 12-lead ECG will be
 performed. Patients will be followed-up clinically after the procedure as per normal clinical
 practice. Follow-up visits will be systematically scheduled at 3, 6, 12, 18 and 24 months.
 12-lead ECG and ICD interrogation will be performed at each follow-up visit. Patients will be
 instructed to immediately contact the center in case of symptoms suggestive of ventricular
 arrhythmias. Documentation for intercurrent events will be requested and collected. The
 maximal duration of study participation for the individual patients is two years.
Inclusion Criteria:

 -  Patients affected by cardiomyopathies with and without documented family history of
 BrS;

 -  Presence of symptoms attributable to VA and/or presenting documented arrhythmic
 episodes;

 -  Patients with an ICD already implanted;

 -  Patients referred to the centre for an electrophysiological study and indication for a
 potential concomitant radio-frequency catheter ablation (RFA) of ventricular
 tachycardia (VT) or ventricular fibrillation (VF);

 -  Age ≥ 18;

 -  Willingness to attend follow-up examinations;

 -  Written informed consent for the participation in the trial

 Exclusion Criteria:

 -  Pregnancy or breast-feeding;

 -  Life expectancy < 12 months