Outcomes of ventricular tachycardia ablation in patients with structural heart disease: The impact of electrical storm.
PLoS One
; 12(2): e0171830, 2017.
Article
en En
| MEDLINE
| ID: mdl-28187168
ABSTRACT
AIMS:
To investigate predictors of long-term outcomes after catheter ablation (CA) for ventricular tachycardia (VT) and the impact of electrical storm (ES) prior to index ablation procedures.METHODS:
We studied consecutive patients with structural heart disease and VT (n = 328; age 63±12 years; 88% males; 72% ischaemic cardiomyopathy; LVEF 32±12%) who had undergone CA. According to presenting arrhythmia at baseline, they were divided into ES (n = 93, 28%) and non-ES groups. Clinical predictors of all-cause mortality were investigated and a clinically useful risk score (SCORE) was constructed.RESULTS:
During a median follow-up of 927 days (IQR 564-1626), 67% vs. 60% of patients (p = 0.05) experienced VT recurrence in the ES vs. the non-ES group, respectively; and 41% vs. 32% patients died (p = 0.02), respectively. Five factors were independently associated with mortality age >70 years (hazard ratio (HR) 1.6, 95% confidence interval (CI) 1.1-2.4, p = 0.01), NYHA class ≥3 (HR 1.9, 95% CI 1.2-2.9, p = 0.005), a serum creatinine level >1.3 mg/dL (HR 1.6, 95% CI 1.1-2.3, p = 0.02), LVEF ≤25% (HR 2.4, 95% CI 1.6-3.5, p = 0.00004), and amiodarone therapy (HR 1.5, 95% CI 1.0-2.2, p = 0.03). A risk SCORE ranging from 0-4 (1 point for either high-risk age, NYHA, creatinine, or LVEF) correlated with mortality. ES during index ablation independently predicted mortality only in patients with a SCORE ≤1.CONCLUSIONS:
Advanced LV dysfunction, older age, higher NYHA class, renal dysfunction, and amiodarone therapy, but not ES, were predictors of poor outcomes after CA for VT in the total population. However, ES did predict mortality in a low-risk sub-group of patients.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Fibrilación Ventricular
/
Taquicardia Ventricular
/
Ablación por Catéter
Tipo de estudio:
Prognostic_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
PLoS One
Asunto de la revista:
CIENCIA
/
MEDICINA
Año:
2017
Tipo del documento:
Article
País de afiliación:
República Checa