Hemodynamic Support in Ventricular Tachycardia Ablation: An International VT Ablation Center Collaborative Group...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Limited real-world data exist on the impact of hemodynamic support (HS) during ventricular tachycardia (VT) ablation.
• Patients undergoing VT ablation often have significant comorbidities affecting outcomes.

Purpose of the Study:

• To evaluate the clinical outcomes of patients receiving hemodynamic support (HS) during ventricular tachycardia (VT) ablation.
• To compare outcomes between patients who received HS and those who did not.

Main Methods:

• Analysis of 1,655 patients from the International VT Ablation Center Collaborative group.
• Comparison of outcomes between 105 patients receiving HS (percutaneous ventricular assist device) and those not receiving HS.

Main Results:

• Patients receiving HS had lower LVEF, higher NYHA class, more ICD shocks, VT storm, and antiarrhythmic drug use.
• The HS group had significantly lower acute procedural success, higher complications, and higher 1-year mortality (HR 5.01).
• No significant difference in VT recurrence was observed; subgroup analysis in severe LV dysfunction/NYHA class showed similar outcomes between groups.

Conclusions:

• Patients requiring HS during VT ablation are generally sicker, with significantly higher 1-year mortality.
• In patients with LVEF ≤20% and NYHA class III-IV, HS did not significantly alter clinical outcomes compared to no HS.
• Further research is needed to systematically evaluate HS in VT ablation patients.