Timing of Catheter Ablation for Ventricular Tachycardia and Prognosis After Emergent Hospitalization - Results From the JROAD-DPC Database.

Abstract

Background: Catheter ablation (CA) for ventricular tachycardia (VT) is an effective treatment for preventing VT recurrence. However, the optimal timing and outcomes of CA for VT during emergent admission remains unclear.

Methods and results: We retrospectively investigated patients who underwent CA for VT after emergent admission between 2012 and 2021 using the Japanese Registry of All Cardiac and Vascular Diseases database. The clinical characteristics, complication and outcomes (primary outcome: in-hospital death; secondary outcome: emergent re-admission for VT within 30 days) were compared between the patients who underwent CA within (CA ≤3) and after (CA >3) the third day of admission. A total of 3,827 patients (787 patients had CA ≤3 days, and 3,040 patients had CA >3 days) was enrolled. Compared with the CA >3 days group, those with CA ≤3 were younger and had less comorbidities of underlying heart diseases and medications. After adjusting for baseline characteristics, CA ≤3 days or >3 days after emergent admission was not associated with in-hospital death and re-admission for VT. Furthermore, the emergent re-admission and overall complication rates were not significantly different between the 2 groups.

Conclusions: The clinical background differed substantially between patients who underwent CA within 3 days and those who underwent CA later during emergency hospitalization. An emergency CA for VT is not strongly recommended; however, it might be acceptable in cases with unavoidable circumstances.