C-43 | Causes and Predictors of 30 Days Readmission After Revascularization For Chronic Total Occlusion in Patients With History of Ventricular Tachycardia: Nationwide Readmissions Database Analysis.

Chronic Total Occlusion (CTO) revascularization poses a distinct technical challenge with increased risk of periprocedural complications without certain benefits. Literature looking into Long term effects in patients with Ventricular Tachycardia (VT) is limited. We looked at readmissions as a marker for long term effect. Nationwide Readmissions Database 2020 was queried to identify adults with CTO-VT and revascularization (PCI or Coronary Artery Bypass Grafting) using ICD-10 CM and PCS codes. All patients with acute myocardial infarction were excluded. Multivariate logistic regression was used to analyze the outcomes. 1,261 encounters of CTO-VT and revascularization were identified, of which 1,181 were discharged alive. The 30 days readmission rates were lower in the revascularized group when compared to the non-revascularized group (17.8% vs 18.7%). Those readmitted in the revascularized group had a higher burden of comorbidities while were similar in demographics and hospital characteristics. Readmissions lead to an additional mean total hospital charge of $77,348 and a mean length of stay of 6.0 days. The major causes of readmissions were VT (21.3%), heart failure with chronic kidney disease (12.3%), hypertensive heart disease with heart failure (8.8%). Figure 1 shows the forest plot of a multivariate analysis of independent factors associated with readmissions. Following revascularization in patients with a history of VT, 1 in 7 patients got readmitted. Readmission was led by VT, which could be explained by reperfusion arrhythmia, followed by heart failure.