Early Mortality After Ventricular Tachycardia Ablation
What is the mortality rate of ventricular tachycardia (VT) catheter ablation (CA) within 31 days of the procedure in patients with structural heart disease (SHD)?
This retrospective cohort study included 2,061 patients (mean age 62 years) with VT who were recruited at 12 centers and who had SHD (mean ejection fraction [EF] 34%, ischemic heart disease in 53%). Multiple variables were analyzed to identify predictors of early mortality after CA.
Early mortality after VT CA was 5%. Sixty percent of these deaths occurred before hospital discharge (median 9 days post-CA). Overall, 0.6% of deaths were attributable to a major procedural complication. The independent predictors of early mortality after CA were: EF (odds ratio [OR] 1.12 per 1% decrease in EF, chronic kidney disease (OR 2.7), presentation with VT storm (OR 3.6), presence of unmappable VT (OR 5.7), and recurrent VT post-ablation (OR 11.4).
The early mortality rate in this large cohort of patients with SHD who underwent CA of VT was 5%. Early mortality can be predicted by several variables that are indicators of more severe SHD and/or unsuccessful or incomplete CA of VT.
The major strength of this study is the very large sample size of >2,000 patients. It is useful to identify predictors of early mortality, but other than using these predictors to screen out high-risk patients, it is not clear how knowledge of these predictors can be used to improve outcomes after VT CA.
Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure
Keywords: Arrhythmias, Cardiac, Catheter Ablation, Coronary Artery Disease, Heart Failure, Mortality, Premature, Myocardial Ischemia, Patient Outcome Assessment, Renal Insufficiency, Chronic, Secondary Prevention, Stroke Volume, Tachycardia, Ventricular
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