Clinical Characteristics and Outcomes of Patients with Heart Failure and Reduced Ejection Fraction Who Underwent Ventricular Tachycardia Ablation

Document Type

Conference Proceeding

Publication Date

2025

Publication Title

Journal of Cardiac Failure

Abstract

Introduction: Patients with heart failure and reduced ejection fraction (HFrEF) are at increased risk of ventricular tachycardia (VT) and sudden cardiac death (SCD). Catheter ablation of VT is a treatment alternative for patients with recurrent VT despite antiarrhythmics. HFrEF patients undergoing VT ablation represent a high-risk population that may benefit from risk stratification for advanced HF therapies, such as left ventricular assist device (LVAD) implantation or heart transplantation (HTx). Our objective was to evaluate the clinical characteristics and long-term outcomes of HFrEF patients undergoing VT ablation at our institution.

Methods: Patients with HFrEF (EF < 40%) who received VT ablation between January, 2018 and May, 2023 at our institution were included. Epidemiological, echocardiographic, and clinical variables were collected. The Kaplan-Meier method was used for survival analysis, outcomes included mortality, LVAD implantation and HTx. Statistical analysis of the association between clinical characteristics and outcomes was performed with Student's t-test, the Wilcoxon signed rank test, Fisher's exact test, or Chi-squared test. Statistical significance was considered if p< 0.05.

Results: A total of 110 patients were included in this study. There are 27 patients reached the primary outcome. Among whom, 26 patients died, 1 patient received an LVAD and heart transplant. The 3 years survival rate was 75.5% (Figure 1). Patients who achieved the primary outcome were classified as non-survivors and the remaining patients are classified ad survivors. Epidemiological, clinical and echocardiographic variables of the two groups are shown in Table 1. The non-survivors cohort has lower blood pressure, higher incidence of chronic kidney disease, larger percentage of NYHA class III/IV, lower left ventricular ejection fraction, more mitral valvular dysfunction, worse right ventricular systolic reduction, and more hospitalization peri-ablation.

Conclusions: Patients with HFrEF undergoing VT ablation are a high-risk population with 1 in every 4 patients either dying or requiring LVAD or HT within 3 years. They require close monitoring and multidisciplinary management from electrophysiologists and advanced HF cardiologists, especially for the early identification of candidates who may benefit from advanced HF therapies.

Volume

31

Issue

1

First Page

337

Comments

Heart Failure Society of America (HFSA) Annual Scientific Meeting, September 27-30, 2024, Atlanta, GA

Frederik Meijer Heart & Vascular Institute

Last Page

337

DOI

10.1016/j.cardfail.2024.10.401

ISSN

1532-8414

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