Ventricular tachycardia ablation in patients with LVEF >30% was associated with a lower 30-day composite safety endpoint compared to LVEF ≤30% (17.9% vs. 26.3%; p=0.0004).
Cohort (n=2,549)
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Does LVEF >30% improve 30-day safety and 3-year outcomes in patients undergoing ventricular tachycardia ablation compared to LVEF ≤30%?
Patients with LVEF >30% undergoing VT ablation have significantly better 30-day safety and 3-year mortality outcomes compared to those with LVEF ≤30%, though VT recurrence remains high in both groups.
Tasa de eventos absoluta: 17.9% vs 26.3%
valor p: p=0.0004
Abstract Background Ventricular tachycardia (VT) ablation is an established therapy for patients with structural heart disease and recurrent VT. However, the impact of left ventricular function on peri-procedural and long-term outcomes remains incompletely understood. We evaluated the association of left ventricular ejection fraction (LVEF) on clinical outcomes after VT ablation. Methods We conducted a retrospective cohort study using the TriNetX Research Network (2010–2021) to evaluate outcomes after VT ablation, stratifying patients by LVEF (30% vs. ≤30%). Propensity score matching (1:1) was used to balance baseline characteristics. The primary outcome was a 30-day composite safety endpoint defined as all-cause mortality, acute kidney injury (AKI), mechanical circulatory support (MCS) use, or cardiac tamponade. Secondary outcomes included 3-year all-cause mortality, ventricular arrhythmia recurrence, and rehospitalization. The individual components of the 30-day composite were evaluated in exploratory analyses. Results Among 2,549 patients who underwent VT ablation, 623 were matched in each subgroup. The 30-day composite safety endpoint was significantly lower in patients with LVEF 30% (17.9% vs. 26.3%; p=0.0004). In exploratory analyses, patients with LVEF ≤30% had higher 30-day mortality, AKI, and MCS use, while tamponade rates were similar between groups. At 3-year follow-up, all-cause mortality (15.2% vs. 28.7%) and rehospitalization (31.6% vs. 44.1%) remained significantly lower (p 0.01) in the higher LVEF group. VT recurrence rates were high in both groups (71% vs. 67%) without a significant difference. Conclusion In this large real-world study, patients with LVEF 30% undergoing VT ablation experienced significantly better peri-procedural and long-term outcomes.
Dulal et al. (Tue,) conducted a cohort in Ventricular tachycardia (n=2,549). LVEF >30% vs. LVEF ≤30% was evaluated on 30-day composite safety endpoint (all-cause mortality, acute kidney injury, mechanical circulatory support use, or cardiac tamponade) (p=0.0004). Ventricular tachycardia ablation in patients with LVEF >30% was associated with a lower 30-day composite safety endpoint compared to LVEF ≤30% (17.9% vs. 26.3%; p=0.0004).