Related Experiment Video

Updated: Jun 11, 2025

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

Published on: January 31, 2019

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Catheter ablation vs advanced therapy for patients with severe heart failure and ventricular electrical storm

Andrew Y Lin1, Maedha Begur1, Emily Margolin1

  • 1Division of Cardiology, Department of Medicine, University of California San Diego, La Jolla, California.

Heart Rhythm
|September 27, 2024
PubMed

Insights

Catheter ablation for ventricular tachycardia electric storm in severe heart failure offers similar survival to advanced therapies. However, heart transplantation rates were high post-ablation, with specific UNOS statuses and early recurrence predicting outcomes.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Limited data exists on comparing catheter ablation versus advanced therapies for severe heart failure (HF) patients experiencing electric storm (ES).
  • Severe HF is defined by ejection fraction ≤ 35% or significant cardiomyopathy.
  • Ventricular ES poses a critical challenge in HF management.

Purpose of the Study:

  • To compare the outcomes of ventricular tachycardia (VT) ablation against advanced therapies (left ventricular assist device [LVAD] or heart transplantation [HT]) in severe HF with ES.
  • To identify factors influencing outcomes in patients undergoing VT ablation.

Main Methods:

  • Retrospective review of 73 patients with severe HF and ES treated between 2012-2022.
  • Patients underwent either VT ablation or advanced therapy (HT/LVAD).
  • In-hospital adverse events and 1-year outcomes were assessed.

Main Results:

  • One-year survival was comparable between VT ablation (76.7%) and advanced therapy (86.7%) groups (P = .308).
  • 23.3% of patients in the ablation group eventually received HT.
  • United Network for Organ Sharing (UNOS) status 1 or 2 and early VT recurrence predicted HT or mortality post-ablation.

Conclusions:

  • Catheter ablation for VT in severe HF with ES shows similar survival to upfront advanced therapy.
  • High rates of subsequent HT were observed after VT ablation.
  • UNOS status and early VT recurrence are key predictors for HT or mortality following ablation.
Abstract

Keywords:
Catheter ablationElectrical stormHeart transplantationLeft ventricular assist deviceSevere heart failure

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