VT recurrence after ablation in nonischemic cardiomyopathy varied significantly by phenotype, ranging from 82.6% in LMNA to 33.8% in ARVC (p=0.027).
Meta-Analysis (n=1,699)
Yes
Does the underlying disease phenotype affect VT recurrence following VT ablation in patients with nonischemic cardiomyopathy?
VT ablation outcomes in nonischemic cardiomyopathy vary significantly by underlying disease phenotype, highlighting the need for phenotype-specific procedural counseling and clinical trial stratification.
p-value: p=0.027
ABSTRACT Background Ventricular tachycardia (VT) ablation outcomes in nonischemic cardiomyopathy (NICM) may differ by disease phenotype, but prior studies have pooled NICM as a single entity. We performed a phenotype‐stratified meta‐analysis of VT ablation outcomes across six major NICM subtypes. Methods We systematically searched PubMed, Embase, and the Cochrane Library through January 2026. Studies were stratified by phenotype: lamin A/C (LMNA), cardiac sarcoidosis, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), myocarditis, and arrhythmogenic right ventricular cardiomyopathy (ARVC). The primary outcome was VT recurrence. Proportions were pooled using restricted maximum likelihood estimation on the logit scale. Phenotype differences were tested via mixed‐effects meta‐regression. Results Eighteen studies (1699 patients) met inclusion criteria after rigorous center‐level overlap resolution. VT recurrence differed significantly across phenotypes (F 5,12 = 3.78, p = 0.027). LMNA had the highest recurrence (82.6%; 95% CI 51.6%–95.5%; k = 5), followed by sarcoidosis (57.1%; 32.2%–78.8%; k = 2), DCM (42.7%; 24.1%–63.6%; k = 4), HCM (36.2%; 23.8%–50.7%; k = 2), myocarditis (34.5%; 27.3%–42.5%; k = 2), and ARVC (33.8%; 16.0%–57.9%; k = 3). Phenotype explained 44.7% of between‐study heterogeneity. Conclusions VT ablation outcomes in NICM varied by the underlying disease phenotype, with recurrence rates ranging from 82.6% in LMNA cardiomyopathy to 33.8% in ARVC. These hypothesis‐generating findings argue against treating NICM as a unified category and provide a foundation for phenotype‐specific procedural counseling and clinical trial stratification that warrants validation in prospective registries.
Singireddy et al. (Fri,) conducted a meta-analysis in Nonischemic cardiomyopathy (n=1,699). Nonischemic cardiomyopathy phenotype vs. Other phenotypes was evaluated on VT recurrence (p=0.027). VT recurrence after ablation in nonischemic cardiomyopathy varied significantly by phenotype, ranging from 82.6% in LMNA to 33.8% in ARVC (p=0.027).