Repeat VT ablation in patients with structural heart disease reduced shock burden by 73% in the first year, despite a 46% VT recurrence rate over 25 months of follow-up.
Cohort (n=210)
No
Does repeat catheter ablation reduce VT recurrence and shock burden in patients with structural heart disease?
Repeat VT ablation in patients with structural heart disease significantly reduces VT and shock burden, despite a high rate of long-term VT recurrence.
AIMS: Recurrences of ventricular tachycardia (VT) after initial catheter ablation is a significant clinical problem. In this study, we report the efficacy and risks of repeat VT ablation in patients with structural heart disease (SHD) in a tertiary single centre over a 7-year period. METHODS AND RESULTS: Two hundred ten consecutive patients referred for repeat VT ablation after previous ablation in our institution were included in the analysis (53% ischaemic cardiomyopathy, 91% males, median age 65 years, mean left ventricular ejection fraction 35%). After performing repeat ablation, the clinical VTs were acutely eliminated in 82% of the patients, but 46% of the cohort presented with VT recurrence during the 25-month follow-up. Repeat ablation led to a 73% reduction of shock burden in the first year and 61% reduction until the end of follow-up. Similarly, VT burden was reduced 55% in the first year and 36% until the end of the study. Fifty-two patients (25%) reached the combined endpoint of ventricular assist device implantation, heart transplantation, or death. Advanced New York Heart Association functional class, anteroseptal substrate, and periprocedural complication after repeat ablation were associated with worse prognosis independently of the type of cardiomyopathy. CONCLUSION: While complete freedom from VT after repeat ablation in SHD was difficult to achieve, ablation led to a significant reduction in VT and shock burden. Besides advanced heart failure characteristics, anteroseptal substrate and periprocedural complications predicted a worse outcome.
Garcia et al. (Thu,) conducted a cohort in Ventricular tachycardia in patients with structural heart disease (n=210). Repeat catheter ablation was evaluated on Ventricular tachycardia recurrence. Repeat VT ablation in patients with structural heart disease reduced shock burden by 73% in the first year, despite a 46% VT recurrence rate over 25 months of follow-up.