Kumar, Saurabh; Romero, Jorge; Mehta, Nishaki K; Fujii, Akira; Kapur, Sunil; Baldinger, Samuel Hannes; Barbhaiya, Chirag R; Koplan, Bruce A; John, Roy M; Epstein, Laurence M; Michaud, Gregory F; Tedrow, Usha B; Stevenson, William G (2016). Long Term Outcomes Following Catheter Ablation of Ventricular Tachycardia in Patients with and without Structural Heart Disease. Heart rhythm, 13(10), pp. 1957-1963. Elsevier 10.1016/j.hrthm.2016.07.001
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BACKGROUND
Long-term outcomes following ventricular tachycardia (VT) ablation are sparsely described.
OBJECTIVES
To describe long term prognosis following VT ablation in patients with no structural heart disease (no SHD), ischemic (ICM) and non-ischemic cardiomyopathy (NICM).
METHODS
Consecutive patients (n=695; no SHD 98, ICM 358, NICM 239 patients) ablated for sustained VT were followed for a median of 6 years. Acute procedural parameters (complete success [non-inducibility of any VT]) and outcomes after multiple procedures were reported.
RESULTS
Compared with patients with no SHD or NICM, ICM patients were the oldest, had more males, lowest left ventricular ejection fraction (LVEF), highest drug failures, VT storms and number of inducible VTs. Complete procedure success was highest in no SHD, compared ICM and NICM patients (79%, 56%, 60% respectively, P<0.001). At 6 years, ventricular arrhythmia (VA)-free survival was highest in no SHD (77%) than ICM (54%) and NICM (38%, P<0.001) and overall survival was lowest in ICM (48%), followed by NICM (74%) and no SHD patients (100%, P<0.001). Age, LVEF, presence of SHD, acute procedural success (non-inducibility of any VT), major complications, need for non-radiofrequency ablation modalities, and VA recurrence were independently associated with all cause mortality.
CONCLUSIONS
Long term follow up following VT ablation shows excellent prognosis in the absence of SHD, highest VA recurrence and transplantation in NICM and highest mortality in patients with ICM. The extremely low mortality for those without SHD suggests that VT in this population is very rarely an initial presentation of a myopathic process.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology |
UniBE Contributor: |
Baldinger, Samuel Hannes |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1547-5271 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Samuel Hannes Baldinger |
Date Deposited: |
29 Jul 2016 11:00 |
Last Modified: |
05 Dec 2022 14:57 |
Publisher DOI: |
10.1016/j.hrthm.2016.07.001 |
PubMed ID: |
27392945 |
Uncontrolled Keywords: |
catheter ablation; ischemic cardiomyopathy; non-ischemic cardiomyopathy; structural heart disease; ventricular tachycardia |
BORIS DOI: |
10.7892/boris.84446 |
URI: |
https://boris.unibe.ch/id/eprint/84446 |
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