Ventricular tachycardia ablation is highly effective and associated with excellent long-term survival in patients without structural heart disease, whereas mortality remains significant in those with ischemic or nonischemic cardiomyopathy despite ablation.
BACKGROUND: Evolving management of coronary artery disease, heart failure, and the use of implantable cardioverter-defibrillators impacts the characteristics of patients with recurrent ventricular tachycardia (VT). We investigated the substrate, procedure, and outcome evolution of all patients referred for VT ablation during the past 8 years. METHODS AND RESULTS: From 1999 to 2006, 493 consecutive patients (358 male, 57+/-16 years) underwent 623 VT ablations: 131 had no structural heart disease (SHD), 213 had ischemic cardiomyopathies (ICMP), and 149 had nonischemic cardiomyopathies (NICMP). Although the main substrate is ICMP, the proportion of NICMP has increased from 27% to 35% (P=0.06) from 1999-2002 to the 2003-2006. The procedure abolished or modified inducible VTs in > or =75% of patients in all groups, but abolition of all monomorphic VTs was achieved in 125 (83%) patients without SHD, 180 (65%) with ICMP, and 99 (51%) with NICMP (P3 years. In contrast, in patients with SHD and recurrent VT, VT ablation can be helpful to suppress drug refractory VT, but long-term mortality remains significant.
Sacher et al. (Sat,) studied this question.
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