Recognition of the causes of early mortality after ventricular tachycardia (VT) ablation in patients with reduced left ventricular ejection fraction is an essential step toward improving post-procedural outcomes. This study sought to determine the causes of early mortality after VT ablation in patients with EF <50% and to understand further the circumstances surrounding death. We performed a retrospective analysis of all patients undergoing VT ablation in patients with EF <50% from January 1, 2013, to November 10, 2021, at the Mayo Clinic. Causes of death were identified through a detailed chart review. A total of 503 patients (mean age 63 ± 13 years, 11.2% female) with EF <50% were included in the study. The 30-day all-cause mortality rate was 5% (25 patients), and the mortality rate due to a procedural complication was 0.4%. Among all 30-day deaths, recurrent VT was the most common primary cause of death (44%). This was followed by decompensated heart failure (28%), procedure-related death (8%), cerebrovascular accident (CVA) (4%), and infection (4%). Most patients (91%) who died from VT had VT recurrence within three days of the ablation. Significant predictors of early mortality included non-ischemic cardiomyopathy, lower LVEF, electrical storm, and ventricular fibrillation. The overall 30-day all-cause mortality rate after catheter ablation of VT in patients with reduced left ventricular ejection fraction was 5%, but the death rate directly due to a procedural complication was only 0.4%. The most common cause of death was recurrent VT, followed by heart failure.

Editor-in-Chief

Kalyanam Shivkumar, MD, PhD, FACC 

CME Editor
Kenneth A. Ellenbogen, MD, FACC

Author
Mahmoud Houmsse, MD, FACC

Important Dates
Date of Release: June 26, 2023
Term of Approval/Date of CME/MOC Expiration: June 25, 2024