Ten‐Year Outcomes and Predictors of Mortality Following Catheter Ablation of Ventricular Tachycardia

作者：Laura Rottner, Andreas Metzner, Matthias Hochadel, Jochen Senges, Stephan Willems, Hüseyin İnce, Lars Eckardt, Thomas Deneke, Patrick Lugenbiel, Johannes Brachmann, K. R. Julian Chun, Roland Richard Tilz, Andreas Rillig · 发表于：Journal of the American Heart Association · 年份：2024 · DOI：10.1161/jaha.124.034814 · 被引用次数：13 · 研究领域：Cardiac Arrhythmias and Treatments、Atrial Fibrillation Management and Outcomes、Cardiac electrophysiology and arrhythmias

BACKGROUND: Catheter ablation is the primary treatment option for idiopathic ventricular tachycardia (VT). It plays a key role in acute therapy of electrical storm, treatment of VTs in patients with structural heart disease (SHD), and can reduce VT burden. Here we report on 10-year clinical outcomes following VT ablation from patients enrolled in the prospective German Ablation Registry. METHODS AND RESULTS: Long-term follow-up was conducted on 334 patients undergoing VT ablation (118/334, 35%) with structurally normal hearts and 216 out of 334 (65%) with SHD, including 161 out of 216 (75%) with ischemic heart disease at 38 centers. Follow-up was completed in 94.8% of patients. Median observation time was 10.8 (4.3-12.3) years, with a 10-year all-cause mortality rate of 39.4%. VT ablation in patients with SHD was associated with worse outcome when compared with patients with structurally normal hearts (estimated 10-year mortality for SHD 54.8% versus structurally normal hearts 12.1%). Estimated 10-year mortality following VT ablation was highest in patients with ischemic heart disease (62.4%). Significant predictors of mortality following VT ablation included age (hazard ratio [HR], 2.35 [1.90-2.92] per decade), left ventricular ejection fraction ≤30% (HR, 2.11 [1.44-3.10]), diabetes (HR, 1.73 [1.14-2.61]), incessant VT (HR, 2.96 [1.74-5.03]), linear lesion (HR, 1.46 [0.99-2.16]), and acute procedural failure (HR, 2.57 [1.39-4.77]). Procedural failure was the only statistical...