Abstract 18895: Freedom From Recurrent Ventricular Tachycardia After Ablation is Associated With Improved All-Cause Mortality
Introduction: ICD therapy and recurrent VT have been shown to increase the risk for mortality. Catheter ablation of ventricular tachycardia has been demonstrated to reduce recurrent episodes of VT but no studies to date have demonstrated a reduction in all-cause mortality.
Methods: Retrospective analysis of all patients referred for ablation of scar-mediated VT from 2004-2011 were reviewed. Acute procedural success and 1 year-freedom from VT recurrence were correlated with all-cause mortality at 1 year. Separate analyses were performed for patients with ICM and NICM and stratified by EF <30%.
Results: A total of 127 patients were included: 63±11 yrs, male 86%, ICM 56% (EF 28±12), NICM 44% (EF 31±15). Antiarrhythmic usage was 87%. Acute procedural success of noninducibility was achieved in 51% of patients with ICM and 38% with NICM. Acute procedural success predicted freedom from mortality for the NICM group (95% vs 67%, p=0.02), but not for the ICM group (76% vs 65%, p=0.43). Freedom from recurrent VT within the 1 year follow-up period was associated with a reduction in all-cause mortality for patients (ICM 82% vs 48%, p=0.005; NICM 100% vs 61%, p=0.006). However, the mean EF was significantly higher in patients who survived at 1 year (ICM 30±12 vs 23±8 ICM, p=0.007; NICM 33±15 vs 22±6, p<0.001). When stratifying patients with EF≤30%, freedom from VT remained a predictor of 1 year survival (ICM 74% vs 42%, p=0.04; NICM 100% vs 50%, p=0.005).
Conclusion: Freedom from VT at 1 year is associated with a reduction in all-cause mortality in patients with ICM and NICM who underwent catheter ablation of VT. EF is also a significant predictor of all-cause mortality, although the association between recurrent VT and mortality remains for when patients with EF<30% are analyzed.
- © 2013 by American Heart Association, Inc.