Abstract 13840: Complications, Procedure-related Death, and In-hospital Mortality After Catheter Ablation for Ventricular Tachycardia in Ischemic and Non-ischemic Dilated Cardiomyopathy
Background and objective: Radiofrequency catheter ablation (RFCA) of ventricular tachycardia (VT) in structural heart disease (SHD) is a complex procedure, often performed in critically ill patients and carries a potential risk for procedure-related complications and death. Yet, successful VT ablation is in many cases crucial for achieving electrical stability in setting of drug-refractory VT. We sought to investigate the safety of VT ablation in patients with severe SHD, as well as to estimate the incidence and the predictors for in-hospital mortality after VT ablation.
Methods: 227 patients with SHD (197 male; mean age 65±12 y; EF% 33±11; ICM 72%) were ablated for recurrent sustained VT. Procedure related complications and in-hospital mortality were analysed.
Results: The overall and major complications rate were 15% and 8.8% respectively. Procedure-related death occurred in one case with subacute STEMI (0.44%). The commonest complications were vascular injury 4.4%, pericardial effusion 2.2%, high-grade AV block 1.8%, pneumonia with respiratory insufficiency 1.3%, cardiogenic shock in 1.3%. Patients with heparin dose > 100 UI/kg have significantly more pericardial effusions, including 2 tamponades. Nine patients (4%) died during the hospitalisation from worsening of heart failure and VT recurrence. Incomplete procedural success was the only predictor for in - hospital mortality HR 11.76 [CI 95% 1.77 - 77.98]; p=0.011.
Conclusion: The RFCA of VT in SHD is associated with a moderate incidence of major complications, but with a low procedure-related mortality. The successful ablation associates with reduced intra-hospital mortality.
- © 2013 by American Heart Association, Inc.