Catheter Ablation -> Ventricular Arrhythmias -> Clinical Trials / Outcomes
D-PO05 - Poster Session V (ID 39)
Poster
D-PO05-201 - Prognostic Impact Of Ventricular Tachycardia Ablation Outcomes On Long-term Mortality In Patients With Nonischemic Dilated Cardiomyopathy According To Different Heart Failure Classes (ID 592)
Authors
- Daniele Muser
- Simon A. Castro
- Ioan Liuba
- Silvia Magnani
- Anwar A. Chahal
- Erica S. Zado
- Gregory E. Supple
- Robert D. Schaller
- Fermin C. Garcia
- Jeffrey Arkles
- Sanjay Dixit
- Matthew C. Hyman
- Ramanan Kumareswaran
- Andrew E. Epstein
- Rajat Deo
- Cory M. Tschabrunn
- Saman Nazarian
- Michael P. Riley
- David S. Frankel
- Francis E. Marchlinski
- Pasquale Santangeli
Abstract
Background: In patients with nonischemic cardiomyopathy (NICM) and recurrent VT, the long-term mortality is highly dependent on the underlying heart failure (HF) class ability to achieve VT control. Data on the prognostic impact of CA outcomes on long-term mortality across different HF classes are limited.
Objective: To evaluate the impact of the outcomes of CA of VT on long-term survival in patients with NICM across different HF classes.
Methods: From January 1999 to December 2014, a total 282 patients with NICM underwent CA at our Institution. We compared long-term mortality rates according to different HF severity classes (NYHA III/IV versus NYHA I/II) between patients with and without successful CA, which was defined as freedom from any recurrent VT at 1-year follow-up.
Results: Overall, 84 (30%) patients (30%) had NYHA class III/IV and 198 (70%) a NYHA class I/II. Patients with NYHA class III/IV had lower left ventricular ejection fraction (median 30 vs. 40%; p<0.01), a higher prevalence of kidney disease (33% vs. 15%; p<0.01), diabetes mellitus (24% vs. 8%; p<0.01) and more frequently presented with VT storm (39% vs. 19%; p<0.01). After a median follow-up of 48 (19-67) months, cumulative survival was lower in patients with NYHA class III/IV compared to those with NYHA class I/II (55% vs. 88%; p<0.01). However, if successful VT ablation was achieved, long-term mortality rates in NYHA III/IV patients were similar to patients with NYHA class I/II (20% vs. 14%; p=0.1) (Figure).
Conclusion: Effective CA of VT in patients with NICM and NYHA class III/IV may reduce mortality to a level comparable to NYHA I/II patients.
Collapse
Objective: To evaluate the impact of the outcomes of CA of VT on long-term survival in patients with NICM across different HF classes.
Methods: From January 1999 to December 2014, a total 282 patients with NICM underwent CA at our Institution. We compared long-term mortality rates according to different HF severity classes (NYHA III/IV versus NYHA I/II) between patients with and without successful CA, which was defined as freedom from any recurrent VT at 1-year follow-up.
Results: Overall, 84 (30%) patients (30%) had NYHA class III/IV and 198 (70%) a NYHA class I/II. Patients with NYHA class III/IV had lower left ventricular ejection fraction (median 30 vs. 40%; p<0.01), a higher prevalence of kidney disease (33% vs. 15%; p<0.01), diabetes mellitus (24% vs. 8%; p<0.01) and more frequently presented with VT storm (39% vs. 19%; p<0.01). After a median follow-up of 48 (19-67) months, cumulative survival was lower in patients with NYHA class III/IV compared to those with NYHA class I/II (55% vs. 88%; p<0.01). However, if successful VT ablation was achieved, long-term mortality rates in NYHA III/IV patients were similar to patients with NYHA class I/II (20% vs. 14%; p=0.1) (Figure).
Conclusion: Effective CA of VT in patients with NICM and NYHA class III/IV may reduce mortality to a level comparable to NYHA I/II patients.
