588The international, multicentre, dilated cardiomyopathy VT ablation registry (DCMVT): acute outcome and follow-up

Abstract

Objective: The aim of our international multicenter registry is to prospectively collect data on patient characteristics, VT substrates, procedural strategies, endpoints and outcome of VT ablation in DCM. Methods: Consecutive patients with DCM accepted for VT ablation in 9 centers were enrolled according to an intention to treat principle. Results: A total of 251 patients (61+/‐13yr, 211 (84%) male, LVEF 35% (IQR 26‐42%) were included since 9/2013. Class 1 or 3 antiarrhythmics failed in 200 (80%), 112 (45%) had >=1 prior ablation, 220 (88%) ICD (CRT in 72(29%)). Prior to the current ablation 99 (39%) presented with electrical storm. Patients were inducible for 2.5+/‐2.1 VTs, 14 were noninducible at baseline. A combined endo/epicardial procedure was performed in 147 (59%) pts. Re‐inducibility was tested as procedural endpoint in 202 (80%). Reasons not to test were hemodynamic condition, no/ineffective ablation or noninducibility at baseline. Noninducibility of any VT was achieved in 126 (50%), 76 (30%) remained inducible for VT; >1(2‐4) procedures were performed in 35 (14%) pts. During 10+/‐10 months follow‐up, 40 (16%) died. VT recurred in 97 (39%), 1yr event free survival was 49% after 1 and 52% after >1 procedures (Figure). Noninducibility (HR 1.62 (95% CI 1.11‐2.37) and better LVEF (HR per quartile 1.21(95%CI 1.02 ‐1.44) were associated with improved outcome. Conclusion: Even when performed in experienced centers with routine use of an endo/epicardial approach, current ablation for VT in patients with DCM is associated with only 50% acute noninducibility and moderate event free survival. (Figure presented).