Intracardiac echocardiography use and outcomes after catheter ablation of ventricular tachycardia

Area of Science:

• Cardiology
• Medical Devices
• Electrophysiology

Background:

• Ventricular tachycardia (VT) ablation is a critical procedure for patients with implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy-defibrillator (CRT-D).
• Optimizing ablation outcomes and reducing readmissions remain key challenges in managing these complex patients.

Purpose of the Study:

• To compare the effectiveness of outpatient VT catheter ablation with and without intracardiac echocardiography (ICE) in patients with ICD/CRT-D devices.
• To assess the impact of ICE use on various patient readmission outcomes.

Main Methods:

• A retrospective study comparing patients undergoing VT ablation with (n=1143) and without (n=1677) ICE, identified via procedure codes.
• Propensity score matching was employed to control for confounding variables.
• Survival analyses and falsification outcomes were used to evaluate the association between ICE use and readmissions.

Main Results:

• Patients who underwent VT ablation with ICE demonstrated a 24% lower risk of all-cause readmissions.
• A 24% reduction in cardiovascular-related and a 20% reduction in VT-related readmissions were observed in the ICE group compared to the non-ICE group.
• Falsification analyses confirmed the robustness of the association between ICE use and improved outcomes, with nonsignificant results for spurious associations.

Conclusions:

• Intracardiac echocardiography (ICE) use during outpatient VT ablation in patients with ICD/CRT-D devices is associated with significantly lower VT-related readmission rates.
• The findings suggest that ICE is a valuable tool for improving procedural success and reducing long-term complications in this patient population.