Long-Term Outcomes of Catheter Ablation in Ventricular Tachycardia Electrical Storm: A Retrospective Cohort Study

Abstract

Background and Objective: Electrical storm is a life-threatening condition commonly observed in patients with structural heart disease. While catheter ablation has emerged as an effective treatment for electrical storm, the long-term outcomes are still unknown. This study aims to evaluate the long-term outcomes of catheter ablation in patients with electrical storm, focusing on mortality, ventricular tachycardia (VT) recurrence, and hospitalization rates. Methods: We conducted a retrospective cohort study at a single center, enrolling 65 patients admitted with electrical storm. All patients underwent catheter ablation The primary outcome was VT-related ICD therapies, while the secondary outcomes included all caused mortality, VT-related ICD therapies, repeat ablation, hospitalization, and stroke. Results: The cohort was predominantly male (86.15%) with ischemic cardiomyopathy (56.92%) and a mean left ventricular ejection fraction (LVEF) of 35.3% ± 13%. All procedures were completed without any fatalities and without significant complications in 93.85% of cases. During follow-up, 22 patients (33.85%) received ICD therapies for VT. The median estimated survival time for the VT-free survival was 43 months. The 12-month mortality rate was 26.15%. Over the median follow-up of 23 months, 40% of patients died, and 72% experienced a composite endpoint of death, VT recurrence, or hospitalization. Multivariate analysis identified reduced LVEF as the strongest predictor of mortality during follow-up. Conclusion: VT ablation is a safe and effective therapeutic option for managing electrical storm, providing high acute procedural success and allowing most patients to be discharged. However, this high-risk population remains at significant risk for long-term morbidity and mortality.