P1059Survival and predictors of mortality after substrate-guided ventricular tachycardia ablation

Abstract

Background: Substrate-guided ablation techniques have permitted to modify the approach and results of ventricular tachycardia (VT) ablation. Complications, longterm survival and predictors of mortality after VT substrate ablation are not well known. Methods and Results: A total of 283 consecutive patients with structural heart disease undergoing substrate-guided VT ablation were prospectively included in the study and followed up. 63% had ischemic cardiomyopathy, 15% arrhythmogenic cardiomyopathy, 10% dilated cardiomyopathy and 12% other etiologies. Scar dechanneling technique was used for substrate ablation in all patients. The procedure complication rate was 7% with one death (0.4%). During a mean follow-up of 28±22 months, 26 (9%) patients died. Mortality was associated with age, diabetes mellitus, hypertension, NYHA class, lower left ventricular ejection fraction (LVEF) and inducibility of any sustained VT after ablation. In a multivariate Cox proportional hazards regression model, age [> 65 years HR 4.11 (1.29 - 13.05), P= 0.17], LVEF < 30% [HR 2.62 (1.11-6.18), P=0.03] and VT inducibility [HR 2.32 (1.03-5.26), P=0.04] were associated with death. Conclusion: Patients undergoing substrate-guided VT ablation show better survival rates that previously reported. Age, LVEF and inducibility after ablation were predictors of total mortality. (Figure Presented).