Abstract 3098: Mortality Following Ablation for Ventricular Tachycardia: Reason for Hope?
Radiofrequency catheter ablation of ventricular tachycardia (VT) in the setting of advanced structural heart disease markedly reduces VT recurrence and need for defibrillator therapy. Despite this, prior studies have documented annual mortality following successful ablation of > 10% per year in this sick patient population. We hypothesized that state of the art cardiovascular care should have an positive impact on mortality following VT ablation compared to earlier reports. Data were reviewed from all patients with structural heart disease who had VT ablation from 1/99 to 12/05. VT ablation was performed in 236 patients. Structural heart disease was ischemic (152 pts), non-ischemic LV myopathy (58), RV cardiomyopathy (22) and congenital heart disease (4). Results: Patients with VT ablation after 1/2003 had significantly better survival over the same follow up period than patients who had ablation before 1/2003 (Figure⇓). 1 and 3 year total mortality was 91 vs. 79% and 77 vs. 68% in the post and pre 1/2003 groups respectively. Conclusions: Mortality following VT ablation in advanced structural heart disease has decreased significantly in recent years. Advances in cardiovascular care, including better pharmacologic therapy for heart failure, more aggressive revascularization and more widescale implementation of cardiac resynchronization therapy may be responsible for this trend.