Key result
In patients who did not achieve VT non-inducibility after ablation, an LVEF ≥35% was an independent predictor of reduced VT recurrence (HR 0.19, p<0.01).
Why the study?
It is unclear whether VT non-inducibility should be used as a routine endpoint of VT ablation.
Does an LVEF ≥35% or elimination of clinical VT predict fewer VT recurrences in patients without VT non-inducibility at the end of ablation?
Cohort (n=62)
No
Does an LVEF ≥35% or elimination of clinical VT predict fewer VT recurrences in patients without VT non-inducibility at the end of ablation?
Hazard Ratio: 0.19 (95% CI 0.06–0.49)
p-value: p=<0.01
Even when complete VT non-inducibility is not achieved during ablation, patients with an LVEF ≥35% or elimination of the clinical VT have favorable recurrence outcomes and significant reduction in VT burden.
May aid post-ablation risk stratification in non-inducible VT; hypothesis-generating and requires prospective validation before guiding practice.
Background Ventricular tachycardia (VT) non‐inducibility at the end of ablation is associated with a less likely VT recurrence. However, it is not clear whether we should use VT non‐inducibility as a routine end point of VT ablation. The aim of this study was to evaluate VT recurrence in patients in whom VT non‐inducibility was not achieved at the end of the radiofrequency (RF) ablation and the factors attributing to the VT recurrence. Methods We analyzed that 62 patients in whom VT non‐inducibility was not achieved at the end of the RF ablation were studied. Results Over 2 years, 22 (35%) of the cases had VT recurrences. A multivariate analysis showed that an LVEF ≥35% (HR: 0.19; 95% CI: 0.06–0.49; p < .01) and elimination of the clinical VT as an acute ablation efficacy (HR: 0.23; 95% CI: 0.04–0.81; p = .02) were independent predictors of fewer VT recurrences. RF ablation was associated with a 91.1% reduction in VT episodes. Conclusion Even if VT non‐inducibility was not achieved, patients with an LVEF ≥35% or in whom the clinical VT could be eliminated might be prevented from having VT recurrences. The validity of the VT non‐inducibility of any VT should be evaluated considering each patient's background and the results of the procedure.
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Nakasone et al. (2022) conducted a cohort in Ventricular tachycardia with structural heart disease (n=62). LVEF ≥35% vs. LVEF <35% was evaluated on Ventricular tachycardia recurrence (HR 0.19, 95% CI 0.06-0.49, p=<0.01). In patients who did not achieve VT non-inducibility after ablation, an LVEF ≥35% was an independent predictor of reduced VT recurrence (HR 0.19, p<0.01).
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