Outcomes following ventricular tachycardia ablation in patients with end-stage kidney disease: US Renal Data System-based outcome data.

Introduction: Data on the outcomes of ablation for paroxysmal ventricular tachycardia (VT) in patients with end-stage renal disease (ESRD) are lacking. This study aimed to identify outcomes of ablation in ESRD patients admitted with paroxysmal VT using the United States Renal Data System (USRDS).

Method: All ESRD adult patients who were hospitalized with paroxysmal VT were included from the USRDS registry. Patients were stratified based on ablation treatment. Baseline characteristics were compared using descriptive statistics, and time-to-event analysis was done with a Kaplan-Meier curve. Cox regression analysis was used to assess hazard ratio (HR) for predictors of mortality.

Results: A total of 8116 patients were identified. Of them, 688 [8.5%] received a VT ablation. Patients in the ablation group were more frequently younger and of African American descent compared to the no ablation group. VT ablation patients had a higher number of hospitalizations. Both groups had a 5-year mortality >75%; patients in the ablation group had a lower 5-year mortality rate (P < 0.001). Age ≥65 (HR 2.36), White race (HR 1.41), history of congestive heart failure (HR 1.40), and history of coronary artery disease (HR 1.73) were significantly associated with mortality.

Conclusion: In selected patients with ESRD and paroxysmal VT, 5-year mortality was lower in those who received an ablation compared to no ablation.