Background: The effects of time to referral for catheter ablation (CA) of scar-related ventricular tachycardia (VT) on acute success, VT recurrence, and cardiac mortality are unclear.
Methods and results: We investigated 300 patients after CA of sustained VT. CA was performed within 30 days after the first documented VT in 75 (25%) patients (group 1), between 1 month and 1 year in 84 (28%) patients (group 2), and >1 year after the first VT occurrence in 141 (47%) patients (group 3). The end points were noninducibility of any VT after CA (acute success), VT recurrence and cardiac mortality after 2 years. Acute success was achieved in 66 (88%) patients in group 1, 68 (81%) in group 2, and in 99 (70.2%) in group 3 (P=0.008). During the 2-year follow-up period, VT recurred in 28 (37.3%) patients in group 1, 52 (61.9%) patients in group 2, and 91 (64.5%) patients in group 3 (P<0.0001). Recurrence-free survival was higher in group 1, as compared with group 2 (hazard ratio [HR], 1.85; P=0.009) and group 3 (HR, 2.04; P=0.001). No survival difference was observed between groups 1 and 2 (HR, 0.85; P=0.68) and groups 1 and 3 (HR, 1.13; P=0.73). β-blocker therapy, VT of ischemic origin, and complete success were associated with VT-free survival. VT recurrence (HR, 1.91; P=0.037) predicted cardiac mortality.
Conclusions: CA of scar-related VT performed within 30 days after the first documented VT was associated with improved acute and long-term success. VT recurrence, but not the early referral for CA, was associated with cardiovascular mortality.
Keywords: catheter ablation; tachycardia, ventricular.
© 2014 American Heart Association, Inc.