Long-term outcome after multiple VT ablations in NICM patients.

Area of Science:

• Cardiology
• Electrophysiology
• Internal Medicine

Background:

• Limited data exists on ventricular tachycardia (VT) ablation outcomes in non-ischemic cardiomyopathies (NICM).
• This study compares acute and long-term results of VT ablation across different NICM subtypes.

Purpose of the Study:

• To evaluate the efficacy and safety of VT ablation in patients with various non-ischemic cardiomyopathies.
• To compare VT recurrence rates and cardiovascular mortality among different NICM etiologies post-ablation.

Main Methods:

• A single-center study included 206 patients with NICM undergoing 323 VT ablations from May 2016 to February 2022.
• Patients were categorized by NICM type (DCM, myocarditis, sarcoidosis, ARVC) to analyze VT recurrence and mortality endpoints.
• Follow-up included assessment of acute procedural success, in-hospital and long-term VT recurrences, and cardiovascular mortality.

Main Results:

• Acute procedural success varied by NICM, highest in ARVC (90%) and lowest in DCM (74%).
• Long-term VT recurrence was highest in DCM (61%) and lowest in sarcoidosis (35%).
• Cardiovascular mortality was 19% overall, significantly higher in DCM patients (log-rank p=0.001).

Conclusions:

• VT ablation offers effective rhythm control for approximately two-thirds of NICM patients.
• Non-clinical VT recurrences are common, especially in DCM, necessitating further procedures.
• DCM patients with VT exhibit the highest cardiovascular mortality, highlighting a critical need for optimized management strategies.