TY - JOUR
T1 - Freedom from recurrent ventricular tachycardia after catheter ablation is associated with improved survival in patients with structural heart disease
T2 - An International VT Ablation Center Collaborative Group study
AU - Tung, Roderick
AU - Vaseghi, Marmar
AU - Frankel, David S.
AU - Vergara, Pasquale
AU - Di Biase, Luigi
AU - Nagashima, Koichi
AU - Yu, Ricky
AU - Vangala, Sitaram
AU - Tseng, Chi Hong
AU - Choi, Eue Keun
AU - Khurshid, Shaan
AU - Patel, Mehul
AU - Mathuria, Nilesh
AU - Nakahara, Shiro
AU - Tzou, Wendy S.
AU - Sauer, William H.
AU - Vakil, Kairav
AU - Tedrow, Usha
AU - Burkhardt, J. David
AU - Tholakanahalli, Venkatakrishna N.
AU - Saliaris, Anastasios
AU - Dickfeld, Timm
AU - Weiss, J. Peter
AU - Bunch, T. Jared
AU - Reddy, Madhu
AU - Kanmanthareddy, Arun
AU - Callans, David J.
AU - Lakkireddy, Dhanunjaya
AU - Natale, Andrea
AU - Marchlinski, Francis
AU - Stevenson, William G.
AU - Della Bella, Paolo
AU - Shivkumar, Kalyanam
N1 - Publisher Copyright:
© 2015 Heart Rhythm Society.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Background The impact of catheter ablation of ventricular tachycardia (VT) on all-cause mortality remains unknown. Objective The purpose of this study was to examine the association between VT recurrence after ablation and survival in patients with scar-related VT. Methods Analysis of 2061 patients with structural heart disease referred for catheter ablation of scar-related VT from 12 international centers was performed. Data on clinical and procedural variables, VT recurrence, and mortality were analyzed. Kaplan-Meier analysis was used to estimate freedom from recurrent VT, transplant, and death. Cox proportional hazards frailty models were used to analyze the effect of risk factors on VT recurrence and mortality. Results One-year freedom from VT recurrence was 70% (72% in ischemic and 68% in nonischemic cardiomyopathy). Fifty-seven patients (3%) underwent cardiac transplantation, and 216 (10%) died during follow-up. At 1 year, the estimated rate of transplant and/or mortality was 15% (same for ischemic and nonischemic cardiomyopathy). Transplant-free survival was significantly higher in patients without VT recurrence than in those with recurrence (90% vs 71%, P <.001). In multivariable analysis, recurrence of VT after ablation showed the highest risk for transplant and/or mortality [hazard ratio 6.9 (95% CI 5.3-9.0), P <.001]. In patients with ejection fraction <30% and across all New York Heart Association functional classes, improved transplant-free survival was seen in those without VT recurrence. Conclusion Catheter ablation of VT in patients with structural heart disease results in 70% freedom from VT recurrence, with an overall transplant and/or mortality rate of 15% at 1 year. Freedom from VT recurrence is associated with improved transplant-free survival, independent of heart failure severity.
AB - Background The impact of catheter ablation of ventricular tachycardia (VT) on all-cause mortality remains unknown. Objective The purpose of this study was to examine the association between VT recurrence after ablation and survival in patients with scar-related VT. Methods Analysis of 2061 patients with structural heart disease referred for catheter ablation of scar-related VT from 12 international centers was performed. Data on clinical and procedural variables, VT recurrence, and mortality were analyzed. Kaplan-Meier analysis was used to estimate freedom from recurrent VT, transplant, and death. Cox proportional hazards frailty models were used to analyze the effect of risk factors on VT recurrence and mortality. Results One-year freedom from VT recurrence was 70% (72% in ischemic and 68% in nonischemic cardiomyopathy). Fifty-seven patients (3%) underwent cardiac transplantation, and 216 (10%) died during follow-up. At 1 year, the estimated rate of transplant and/or mortality was 15% (same for ischemic and nonischemic cardiomyopathy). Transplant-free survival was significantly higher in patients without VT recurrence than in those with recurrence (90% vs 71%, P <.001). In multivariable analysis, recurrence of VT after ablation showed the highest risk for transplant and/or mortality [hazard ratio 6.9 (95% CI 5.3-9.0), P <.001]. In patients with ejection fraction <30% and across all New York Heart Association functional classes, improved transplant-free survival was seen in those without VT recurrence. Conclusion Catheter ablation of VT in patients with structural heart disease results in 70% freedom from VT recurrence, with an overall transplant and/or mortality rate of 15% at 1 year. Freedom from VT recurrence is associated with improved transplant-free survival, independent of heart failure severity.
KW - Ablation
KW - Ventricular tachycardia
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U2 - 10.1016/j.hrthm.2015.05.036
DO - 10.1016/j.hrthm.2015.05.036
M3 - Article
C2 - 26031376
AN - SCOPUS:84939777497
SN - 1547-5271
VL - 12
SP - 1997
EP - 2007
JO - Heart Rhythm
JF - Heart Rhythm
IS - 9
ER -