Predictive value of programmed ventricular stimulation after catheter ablation of post-infarction ventricular tachycardia

Miki Yokokawa, Hyungjin Myra Kim, Kazim Baser, William Stevenson, Koichi Nagashima, Paolo Della Bella, Pasquale Vergara, Gerhard Hindricks, Arash Arya, Katja Zeppenfeld, Marta De Riva Silva, Emile G. Daoud, Sunil Kumar, Karl Heinz Kuck, Ronald Tilz, Shibu Mathew, Hamid Ghanbari, Rakesh Latchamsetty, Fred Morady, Frank M. Bogun

Research output: Contribution to journalArticlepeer-review

Abstract

Background A recent meta-analysis demonstrated a survival benefit in post-infarction patients whose ventricular tachycardia (VT) was rendered noninducible by catheter ablation. Furthermore, patients with noninducible VT had a lower VT recurrence rate than did patients whose VT remained inducible after ablation. Objectives The purpose of this multicenter cohort study was to assess whether noninducibility after VT ablation is independently associated with improved survival. Methods Data from 1,064 patients who underwent VT ablation for post-infarction VT at seven international centers were analyzed. The ablation procedure was considered successful if no VT was inducible at the end of the procedure and unsuccessful if VT remained inducible or if programmed stimulation was not performed at the end of the ablation. Results Median follow-up time was 633 days. Noninducibility was independently associated with lower mortality (adjusted hazard ratio: 0.65; 95% confidence interval: 0.53 to 0.79; p <0.001). Atrial fibrillation, diabetes, and age were other independent predictors of higher mortality. Ablation of only the clinical VT in patients who also had inducible, nonclinical VTs was not associated with improved survival. Conclusions Noninducibility after VT ablation in patients with post-infarction VT is independently associated with lower mortality during long-term follow-up.

Original languageEnglish
Pages (from-to)1954-1959
Number of pages6
JournalJournal of the American College of Cardiology
Volume65
Issue number18
DOIs
Publication statusPublished - May 12 2015

Keywords

  • ablation
  • mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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