TY - JOUR
T1 - Impact of race on outcomes from catheter ablation of ventricular tachycardia in structural heart disease
T2 - A prospective registry from south metropolitan Chicago
AU - Kong, Nathan W.
AU - Shatz, Dalise Y.
AU - Besser, Stephanie A.
AU - Upadhyay, Gaurav A.
AU - Tung, Roderick
N1 - Funding Information:
The authors have no funding sources to disclose. The authors have no conflicts of interest to disclose. All authors attest they meet the current ICMJE criteria for authorship. All patients provided written informed consent. The University of Chicago Medical Center Institutional Review Board approved the creation, maintenance, and review of this prospective registry. The research reported adhered to the Declaration of Helsinki as revised in 2013. The datasets generated and used during the current study are available from the corresponding author on reasonable request.
Publisher Copyright:
© 2023 Heart Rhythm Society
PY - 2023/3
Y1 - 2023/3
N2 - Background: Whether racial disparities in outcomes are present after catheter ablation for scar-related ventricular tachycardia (VT) is not known. Objective: The purpose of this study was to examine whether racial differences exist in outcomes for patients undergoing VT ablation. Methods: From March 2016 through April 2021, consecutive patients undergoing catheter ablation for scar-related VT at the University of Chicago were prospectively enrolled. The primary outcome was VT recurrence, with secondary outcome of mortality alone and composite endpoint of left ventricular assist device placement, heart transplant, or mortality. Results: A total of 258 patients were analyzed: 58 (22%) self-identified as Black, and 113 (44%) had ischemic cardiomyopathy. Black patients had significantly higher rates of hypertension (HTN), chronic kidney disease (CKD), and VT storm at presentation. At 7 months, Black patients experienced higher rates of VT recurrence (P = .009). However, after multivariable adjustment, there were no observed differences in VT recurrence (adjusted hazard ratio [aHR] 1.65; 95% confidence interval [CI] 0.91–2.97; P = .10), all-cause mortality (aHR 0.49; 95% CI 0.21–1.17; P = .11), or composite events (aHR 0.76; 95% CI 0.37–1.54; P = .44) between Black and non-Black patients. Conclusion: In this diverse prospective registry of patients undergoing catheter ablation for scar-related VT, Black patients experienced higher rates of VT recurrence compared to non-Black patients. When adjusted for highly prevalent HTN, CKD, and VT storm, Black patients had comparable outcomes as non-Black patients.
AB - Background: Whether racial disparities in outcomes are present after catheter ablation for scar-related ventricular tachycardia (VT) is not known. Objective: The purpose of this study was to examine whether racial differences exist in outcomes for patients undergoing VT ablation. Methods: From March 2016 through April 2021, consecutive patients undergoing catheter ablation for scar-related VT at the University of Chicago were prospectively enrolled. The primary outcome was VT recurrence, with secondary outcome of mortality alone and composite endpoint of left ventricular assist device placement, heart transplant, or mortality. Results: A total of 258 patients were analyzed: 58 (22%) self-identified as Black, and 113 (44%) had ischemic cardiomyopathy. Black patients had significantly higher rates of hypertension (HTN), chronic kidney disease (CKD), and VT storm at presentation. At 7 months, Black patients experienced higher rates of VT recurrence (P = .009). However, after multivariable adjustment, there were no observed differences in VT recurrence (adjusted hazard ratio [aHR] 1.65; 95% confidence interval [CI] 0.91–2.97; P = .10), all-cause mortality (aHR 0.49; 95% CI 0.21–1.17; P = .11), or composite events (aHR 0.76; 95% CI 0.37–1.54; P = .44) between Black and non-Black patients. Conclusion: In this diverse prospective registry of patients undergoing catheter ablation for scar-related VT, Black patients experienced higher rates of VT recurrence compared to non-Black patients. When adjusted for highly prevalent HTN, CKD, and VT storm, Black patients had comparable outcomes as non-Black patients.
KW - Catheter ablation
KW - Health care disparities
KW - Prospective registry
KW - Race
KW - Ventricular tachycardia
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U2 - 10.1016/j.hroo.2023.01.007
DO - 10.1016/j.hroo.2023.01.007
M3 - Article
AN - SCOPUS:85148374097
SN - 2666-5018
VL - 4
SP - 215
EP - 222
JO - Heart Rhythm O2
JF - Heart Rhythm O2
IS - 3
ER -