Non-ischemic cardiomyopathy was associated with higher VT recurrence than ischemic cardiomyopathy after VT ablation in patients with LVEF >35% (42% vs 25%; HR 2.312; 95% CI 1.3-4.0; p=0.004).
Cohort (n=219)
Does catheter ablation provide effective arrhythmia control and acceptable safety in patients with structural heart disease and LVEF > 35%, and how do outcomes differ between ischemic and non-ischemic cardiomyopathy?
Catheter ablation for VT in structural heart disease patients with LVEF > 35% is safe and provides moderate arrhythmia control, with significantly better outcomes in ischemic compared to non-ischemic cardiomyopathy.
Hazard Ratio: 2.312 (95% CI 1.3–4)
Absolute Event Rate: 42% vs 25%
p-value: p=0.004
BACKGROUND: In patients with structural heart disease (SHD) and moderately impaired left ventricular ejection fraction (LVEF > 35%), data on outcomes after ventricular tachycardia (VT) ablation remain limited. This analysis focuses on VT recurrence after ablation in patients presenting with sustained VT and LVEF > 35% within a secondary-prevention population. OBJECTIVE: To evaluate procedural outcomes and long-term VT recurrence after catheter ablation in SHD patients with LVEF > 35%. METHODS: We analyzed 219 consecutive patients with SHD and LVEF > 35% undergoing VT ablation, including 89 with ischemic cardiomyopathy (ICM) and 130 with non-ischemic cardiomyopathy (NICM). Procedural characteristics, complications, and VT recurrence during follow-up were compared between groups. RESULTS: ICM patients were older, more frequently hypertensive, and had slightly lower LVEF than NICM patients. Ablation was predominantly endocardial in ICM, whereas combined endocardial-epicardial ablation was required in 28% of NICM patients (p 35% was associated with acceptable safety and moderate arrhythmia control. Outcomes were more favorable in ICM than in NICM, reflecting the heterogeneity of arrhythmic risk in this secondary prevention population.
Waezsasa et al. (Sun,) conducted a cohort in Structural heart disease with LVEF > 35% and sustained ventricular tachycardia (n=219). Non-ischemic cardiomyopathy (NICM) vs. Ischemic cardiomyopathy (ICM) was evaluated on VT recurrence (HR 2.312, 95% CI 1.3-4.0, p=0.004). Non-ischemic cardiomyopathy was associated with higher VT recurrence than ischemic cardiomyopathy after VT ablation in patients with LVEF >35% (42% vs 25%; HR 2.312; 95% CI 1.3-4.0; p=0.004).