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PO-01-142 CATHETER ABLATION FOR VENTRICULAR ARRHYTHMIA: AN ANALYSIS OF ELECTROPHYSIOLOGIC CHARACTERISTICS AND THEIR IMPACT ON OUTCOMES
Abstract   Peer reviewed

PO-01-142 CATHETER ABLATION FOR VENTRICULAR ARRHYTHMIA: AN ANALYSIS OF ELECTROPHYSIOLOGIC CHARACTERISTICS AND THEIR IMPACT ON OUTCOMES

Narut Prasitlumkum, Hina Amin, Suganya Arunachalam Karikalan, Pragyat Futela, Tiffany J. Woelber, Kiyan Heybati, Aishwarya Pradeep, Malini Madhavan, Siva K. Mulpuru, Abhishek J. Deshmukh, …
Heart rhythm, Vol.21(5 Suppl), pp.S148-S148
05/2024
DOI: 10.1016/j.hrthm.2024.03.553

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Abstract

Background Ventricular tachycardia (VT) ablation in structural heart disease improves arrhythmia free survival. Procedural factors that influence these outcomes are not well described. Objective To compare the EP characteristics and procedural differences between patients who experience VT recurrence and those who do not. Methods A single-center, retrospective study of patients undergoing VT ablation from 2012 to 2022 was conducted. Demographic data, comorbidities, medications, relevant laboratory abnormalities, electrocardiograms, echocardiograms, detailed procedural characteristics, and outcomes were collected. Results Of 508 VT ablation procedures, 261 experienced a recurrence after a mean follow-up of 1045.8 (± 990.4) days. Patients with VT recurrence were predominantly male (88.5% vs 78.9%, p<0.01) with a mean age of 60.7±13.7 yrs, with a higher frequency of CHF, and Afib, and were on more antiarrhythmic drugs (AAD), at baseline and post-procedure. Patients with VT recurrence required less VT induction meds (15.1% vs 25.4%. p<0.01) but had undergone more entrainment mapping (34.1% vs 23.5%, p<0.01). Post-ablation, there was more inducibility of VT (26.2 vs 17.3 p= 0.03) in the recurrent ventricular arrhythmia group, mainly driven by a difference in non-clinical VT induction (41.6% vs 24.3%, p<0.01). VT-inducibility post-ablation was an independent predictor of VT recurrence in a Cox-proportional Hazard model [aHR 1.82 (1.23-2.71), p<0.01]. Long-term mortality was similar between the two groups on Kaplan-Meir analysis. Conclusion Patients with VT recurrence after ablation have a higher pre-existing arrhythmia and comorbidity burden, which may reflect a more diseased substrate. The inducibility of any VT after ablation is associated with a higher probability of VT recurrence, adding to the data advocating for additional substrate ablation to target all inducible VTs.

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