Emergent Ablation for Ventricular Tachycardia: Predictors of Prolonged Hospitalization and Mortality (JCEP December 2024)-Article: Emergent Ablation for Ventricular Tachycardia: Predictors of Prolonged Hospitalization and Mortality

Article: Emergent Ablation for Ventricular Tachycardia: Predictors of Prolonged Hospitalization and Mortality

Pdf Summary

The study explores predictors of prolonged hospitalization and mortality following emergent ventricular tachycardia (VT) ablation in patients with structural heart disease. Fifty consecutive patients requiring urgent VT ablation were analyzed for outcomes and complications post-procedure. Key findings included that patients with New York Heart Association (NYHA) functional class III or higher and those with a history of failed VT ablation were more likely to experience prolonged hospitalization. The study revealed that 44% of patients had hospital stays over seven days or died within that period post-procedure.<br /><br />The results indicated that those with worse NYHA classes and prior treatment failures experienced higher rates of hospital readmission and mortality within 30 days of the procedure. The risk factors identified for hospital admission durations over 7 days also included presentation with VT storm and high procedural complexity, including more induced VT during procedures and longer anesthesia time.<br /><br />Moreover, post-procedure, Group 2 patients (hospitalized for >7 days or who died) showed significantly higher instances of worsening heart failure and higher VT recurrence rates. The study concluded that pre-procedure evaluation parameters such as NYHA class and failed prior ablations were important in predicting prolonged hospital stays, which correlated with increased short-term mortality.<br /><br />This study highlights the need for careful pre-procedural assessments to optimize management strategies for those exhibiting high-risk factors, indicating the potential benefits of optimized heart failure treatment prior to undertaking emergent VT ablation to improve outcomes.<br /><br />Overall, the research stresses the importance of considering baseline health indicators like NYHA classification and prior ablation failures as significant predictors of poor outcomes in emergent VT ablation cases. Steps should be taken to address these factors to enhance patient recovery and reduce mortality rates associated with high-risk VT management procedures.

Keywords

ventricular tachycardia

VT ablation

structural heart disease

NYHA class

prolonged hospitalization

mortality predictors

heart failure

pre-procedural assessment

VT recurrence

emergent procedures