Key result
Inducibility of more than two VTs during a successful ventricular tachycardia ablation independently predicted arrhythmia recurrence (HR 2.15; p=0.039).
Why the study?
Recurrent ventricular tachycardia occurs in some patients even after successful ventricular tachycardia ablation, prompting an assessment of long-term predictors of recurrence.
Does the inducibility of more than two VTs during a successful ablation procedure predict VT recurrence in patients undergoing ventricular tachycardia ablation?
Cohort (n=111)
No
Does the inducibility of more than two VTs during a successful ablation procedure predict VT recurrence in patients undergoing ventricular tachycardia ablation?
Hazard Ratio: 2.15
Absolute Event Rate: 56.67% vs 24.69%
p-value: p=0.039
The inducibility of more than two VTs during a successful VT ablation procedure is an independent predictor of VT recurrence, identifying a high-risk group that requires vigorous follow-up.
VT recurs in >25% after successful ablation; retrospective data leaves open which predictors should guide intensified surveillance.
Even after a successful ventricular tachycardia ablation (VTA), some patients have recurrent ventricular tachycardia (VT) during their follow-up. We assessed the long-term predictors of recurrent VT after having a successful VTA. The patients who underwent a successful VTA (defined as the non-inducibility of any VT at the procedure’s end) in 2014–2021 at our center in Israel were retrospectively analyzed. A total of 111 successful VTAs were evaluated. Out of them, 31 (27.9%) had a recurrent event of VT after the procedure during a median follow-up time of 264 days. The mean left ventricular ejection fraction (LVEF) was significantly lower among patients with recurrent VT events (28.9 ± 12.67 vs. 23.53 ± 12.224, p = 0.048). A high number of induced VTs (>two) during the procedure was found to be a significant predictor of VT recurrence (24.69% vs. 56.67%, 20 vs. 17, p = 0.002). In a multivariate analysis, a lower LVEF (HR, 0.964; p = 0.037) and a high number of induced VTs (HR, 2.15; p = 0.039) were independent predictors of arrhythmia recurrence. The inducibility of more than two VTs during a VTA procedure remains a predictor of VT recurrence even after a successful VT ablation. This group of patients remains at high risk for VT and should be followed up with and treated more vigorously.
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Nissan et al. (2023) conducted a cohort in Ventricular tachycardia (n=111). Inducibility of >2 VTs during the procedure vs. Inducibility of ≤2 VTs was evaluated on Ventricular tachycardia recurrence (HR 2.15, p=0.039). Inducibility of more than two VTs during a successful ventricular tachycardia ablation independently predicted arrhythmia recurrence (HR 2.15; p=0.039).
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