Background: Catheter ablation is the primary treatment option for idiopathic ventricular tachycardia (VT), plays a key role in acute therapy of electrical storm and treatment of VTs in patients with structural heart disease (SHD), and can reduce VT-burden. However, data on long-term outcome following VT-ablation, is lacking.
Aim: We report on 10-year clinical outcomes following VT-ablation from patients enrolled in the prospective German Ablation Registry.
Methods: Long-term follow-up was conducted on 334 patients undergoing VT-ablation (118/334 (35%) with structural normal hearts (SNH) and 216/334 (65%) with SHD; 161/216 (75%) with ischemic heart disease (IHD)) at 38 centers.
Results: Follow-up was completed in 94.8% of patients. Median follow-up duration was 10.8 (4.3; 12.3) years, with a mortality rate of 37.8%. VT-ablation in patients with SHD was associated with worse long-term outcome when compared to patients with SNH (estimated 10-year mortality for SHD 53.4% vs. SNH 12.1%). Estimated 10-year mortality following VT ablation was highest in patients with IHD (60.5%). Predictors of long-term mortality following VT-ablation included age (hazard ratio [HR] 2.31 [1.87-2.86] per decade), LVEF ≤ 30% (HR 2.23 [1.53-3.24]), diabetes (HR 1.56 [1.01-2.41]), incessant VT (HR 2.13 [1.23-3.67]), linear lesion (HR 1.77 [1.20-2.63]), and acute procedural failure (HR 2.04 [1.08-3.86]). Procedural failure was the only independent predictor for VT-recurrence during 10-years follow-up (HR 3.76 [1.59-8.91]).
Conclusion: VT-ablation results in satisfying 10-year clinical outcome. All-cause mortality after VT-ablation is worse in patients with SHD when compared to patients with SNH, and highest for patients with IHD. Acute procedural success plays a major role VT-recurrence and long-term mortality.
