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PO-01-149 DIFFERENCES IN THE OUTCOMES OF CATHETER ABLATION FOR VENTRICULAR TACHYCARDIA IN NON-ISCHEMIC VERSUS ISCHEMIC CARDIOMYOPATHY
Abstract   Peer reviewed

PO-01-149 DIFFERENCES IN THE OUTCOMES OF CATHETER ABLATION FOR VENTRICULAR TACHYCARDIA IN NON-ISCHEMIC VERSUS ISCHEMIC CARDIOMYOPATHY

Tiffany J. Woelber, Pragyat Futela, Narut Prasitlumkum, Hina Amin, Aishwarya Pradeep, Suganya Arunachalam Karikalan, Kiyan Heybati, Konstantinos C. Siontis, Ammar M. Killu, Suraj Kapa, …
Heart rhythm, Vol.21(5 Suppl), pp.S151-S152
05/2024
DOI: 10.1016/j.hrthm.2024.03.560

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Abstract

Background Catheter ablation is an effective tool to reduce ventricular tachycardia (VT) burden. There is a lack of robust data studying the intraprocedural characteristics and outcomes of VT ablation in patients with non-ischemic (NICM) versus ischemic cardiomyopathy (ICM). Objective To assess the impact of NICM vs ICM on outcomes of VT ablation. Methods A single-center, retrospective study of patients undergoing catheter ablation for VT was conducted. Data collected included demographics, comorbidities, medications, relevant laboratory abnormalities, electrocardiograms, echocardiograms, detailed procedural characteristics, and outcomes. Results Included were 399 patients undergoing 508 VT ablation procedures. The NICM group (284 procedures) was compared to the ICM group (224 procedures). Patients in the ICM group were older and had more comorbidities including hypertension, diabetes, and prior myocardial infarction [Figure]. They also had lower left ventricular ejection fractions (36.9 ± 15.2 vs. 42.8 ± 15.9). The inducibility of VT and the number of VT morphologies induced during the cases were similar between the two groups. However, the NICM group was more hemodynamically unstable during VT (p<0.01). Patients in the NICM group had a lower VT-free survival as determined by Kaplan-Meier analysis (p<0.01) [Figure]. The presence of NICM demonstrated a greater than 2-fold increase in the risk of VT recurrence or the need for a repeat ablation when adjusted for age, sex, and comorbidities in a multivariate regression model (adjusted hazard ratio [aHR] = 2.27; CI = 1.73-2.99). Conclusion Within the NICM group, patients undergoing VT ablation were observed to be younger with fewer comorbidities. However, they exhibited significantly less VT-free survival (p<0.01) after adjusting for age, sex, and comorbidities, likely owing to a more challenging substrate responsible for VT.

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