Adlan, Ahmed M, Arujuna, Aruna, Dowd, Rory, Hayat, Sajad, Panikker, Sandeep, Foster, Will, Yusuf, Shamil, Umar, Fraz, Lellouche, Nicolas, Osman, Faizel and Dhanjal, Tarvinder (2019) Long-term follow-up of normal and structural heart ventricular tachycardia catheter ablation : real-world experience from a UK tertiary centre. Open Heart, 6 (2). e000996. doi:10.1136/openhrt-2018-000996 ISSN 2053-3624.

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Abstract

Background: Ventricular tachycardia (VT) is associated with increased morbidity and mortality. There is growing evidence for the effectiveness of catheter ablation in improving outcomes in patients with recurrent VT. Consequently the threshold for referral for VT ablation has fallen over recent years, resulting in increased number of procedures.

Objective: To evaluate the effectiveness and safety of VT ablation in a real-world tertiary centre setting.

Methods: This is a prospective analysis of all VT ablation cases performed at University Hospital Coventry. Follow-up data were obtained from review of electronic medical records and patient interview. The primary endpoint for normal heart VT was death, cardiovascular hospitalisation and VT recurrence, and for structural heart VT was arrhythmic death, VT storm (>3 episodes within 24 hours) or appropriate shock.

Results: Forty-seven patients underwent 53 procedures from January 2012 to January 2018. The mean age ±SD was 57±15 years, 68% were male, 81% were Caucasian and 66% were elective cases. The aetiology of VT included normal heart (49%), ischaemic cardiomyopathy (ICM, 36%), dilated cardiomyopathy (9%), hypertrophic cardiomyopathy (4%) and valvular heart disease (2%). Procedural success occurred in 83%, with six major complications. After a median follow-up of 231 days (lower quartile 133, upper quartile 631), the primary outcome occurred in 28% of patients. There were two non-arrhythmic deaths (4%). At a median follow-up of 193 days (129–468), the primary outcome occurred in 19% of patients with ICM, while VT storm/appropriate shocks occurred in three patients (17%).

Conclusions: Our real-world registry confirms that VT ablation is safe, and is associated with high acute procedural success and long-term outcomes comparable with randomised controlled studies.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Ventricular tachycardia, Congestive heart failure -- Treatment, Catheter ablation
Journal or Publication Title:	Open Heart
Publisher:	B M J Group
ISSN:	2053-3624
Official Date:	2019
Dates:	Date Event 2019 Published 24 September 2019 Available 12 September 2019 Accepted
Volume:	6
Number:	2
Article Number:	e000996
DOI:	10.1136/openhrt-2018-000996
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	17 January 2020
Date of first compliant Open Access:	30 January 2020

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