Periprocedural Outcomes of VT Ablation in Ischemic Compared to Non‐Ischemic Dilated Cardiomyopathy

BACKGROUND: Patients with structural heart disease undergoing catheter ablation (CA) for VT have shown higher procedural-related adverse events. However, periprocedural outcomes comparing CA for VT in different cardiomyopathies are not well known. We aim to study short-term outcomes of CA in ischemic (ICM) compared to non-ischemic dilated cardiomyopathy (NIDCM). METHODS: The national readmission database (2016-2020) was used to identify hospitalizations for CA for VT. Cohorts were stratified based on underlying cardiomyopathy. A Propensity Score Matching (PSM) model matched ICM to NIDCM patients. Pearson's Chi-squared test was applied to PSM-matched cohorts to compare outcomes. RESULTS: Among 7081 hospitalizations for VT ablation, 17.5% of patients had underlying NIDCM, while 82.5% of patients had ICM. On a PSM analysis (N: 3534), ICM patients had higher incidences of sudden cardiac arrest (SCA) (7.9% vs. 5.6%, p < 0.001), major adverse cardiac events (11.1% vs. 9%, p: 0.006), and cardiogenic shock (10.8% vs. 8.5%, p: 0.001). Interestingly, NIDCM patients were found to have much higher rates of pericardial complications (6.09% vs. 1.90%, p < 0.001), while the mortality difference was not significant (p > 0.05). From 2016 to 2020, in-hospital mortality rates have not changed significantly in ICM and NIDCM cases admitted for VT ablation (p-trend > 0.05); however, there was a decreasing trend of SCA cases in NIDCM hospitalizations (8.7%-3.4%, p-trend: 0.028). NIDCM patients had higher readmission rates at 30 days (18% vs. 15.5%, p: 0.01), 90-day (32.3% vs. 29.6%, p: 0.041), and 180-day (44% vs. 38.2%, p: 0.001). CONCLUSION: VT ablation in ICM patients was associated with higher non-fatal periprocedural events. NIDCM patients showed higher all-cause readmission rates.