Long-term outcomes of ventricular tachycardia ablation in ischemic and non-ischemic cardiomyopathy patients: Data from a single center ablation registry.

Objective: Catheter ablation is effective in the treatment of ventricular tachycardia (VT). However, long-term outcomes after VT ablation in non-ischemic cardiomyopathy are sparsely described. We aimed to compare the outcomes of VT ablation between patients with ischemic cardiomyopathy (ICMP) and non-ischemic cardiomyopathy (NICMP).

Methods: Acute procedural and long-term outcomes of 212 consecutive patients (ICMP, 135; NICMP, 77) who were ablated for sustained VT and followed for a median of 36 months were gathered and analyzed.

Results: Compared with patients with NICMP, patients with ICM were older, more likely to be men, had lower LVEF, more comorbidities, and had a higher number of inducible VTs. Complete procedure success was higher in patients from the NICMP group (88.3 % in NICMP compared to 79.3 % in ICMP). VT recurrence occurred in 54.8 % of ICMP compared to 38.9 % of NICMP (P value = 0.026). The overall mortality rate was 22 % in the ICMP group, compared to 7 % in the NICMP group (P value = 0.007). Additionally, cardiac mortality occurred significantly more in the ICMP group than in the NICMP group (19 % vs. 6 %) (P value = 0.011).

Conclusion: VT ablation in patients with NICMP was found to be an effective and safe approach, achieving acute procedural success in a noticeable number of patients using the currently available catheter mapping and ablation techniques with acceptable low procedural complications. Overall, procedural failures were significantly more frequent in ICMP patients than in NICMP and were consistent with unhealthier long-term outcomes.