Abstract 20883: Predictors of VT Recurrence and Mortality After Cardiac Sympathetic Denervation for Refractory VT - An International Global Cardiac Sympathetic Denervation Collaborative Study (IGCSD)
Introduction: Bilateral cardiac sympathetic denervation (CSD) has been shown to reduce ventricular tachy-arrhythmia (VT) recurrence and improve burden of defibrillator shocks in patients with structural heart disease and refractory VT.
Hypothesis: The purpose of this study was to evaluate factors that predict VT recurrence and mortality in patients who have undergone CSD.
Methods: Retrospective data of 126 patients from four international centers who underwent CSD for refractory VT from 2009 to 2015 was analyzed. Data on clinical and arrhythmia characteristics, VT recurrence, and mortality were analyzed. Kaplan-Meier analysis was used to estimate freedom from recurrent VT, transplant, and death. Cox proportional hazards models were used to analyze the effect of risk factors on VT recurrence and mortality. Patients underwent a median of 12 months of follow-up. The primary outcomes were VT recurrence or combined end point of VT recurrence, mortality, and cardiac transplantation (OHT)
Results: In the univariate analysis, age, number of VT morphologies, slower VT cycle-length (> 400 ms), chronic renal insufficiency, diabetes, and New York Association Class (NYHA) proved statistically significant for combined endpoint of VT recurrence and mortality (P<0.05), while ejection fraction and gender had no effect. However, in multivariable analysis that included the significant variables, only NYHA class IV remained a predictor of VT recurrence and the combined endpoint of VT recurrence/mortality/OHT (HR 13.6 (CI 2.4-78, P < 0.01 and HR 4.9 (CI 1.2-20, P = 0.03), respectively), There was a trend for NYHA Class III as a predictor of VT recurrence (HR 3.9, P = 0.07).
Conclusions: In this multi-center international study of the largest number patients undergoing BCSD to date, the only predictor of VT recurrence or combined endpoint of VT recurrence/mortality/ OHT was severity of heart failure.
Author Disclosures: M. Vaseghi: None. P. Barwad: None. F. Malavassi Corrales: None. H. Tandri: None. N. Mathuria: None. R. Shah: None. L.C. Sáenz: None. Y. Lokhandwala: None. K. Shivkumar: None.
- © 2016 by American Heart Association, Inc.