Impact of Ventricular Tachycardia Ablation on Acute Heart Failure With Reduced Ejection Fraction
Document Type
Conference Proceeding
Publication Date
5-2024
Publication Title
Heart Rhythm
Abstract
Background: Catheter ablation for ventricular tachycardia (VT) has been shown to decrease the risk of VT recurrence and hospitalization. However, a critical gap exists in national-level data assessing its impact on hospital outcomes in patients with acute heart failure with reduced ejection fraction (HFrEF). Objective: This study aimed to compare the hospital outcomes between patients with acute HFrEF who underwent VT ablation vs. those who did not. Methods: Using the all-payer, nationally representative Nationwide Readmissions Database, our study included admitted patients aged 18 years or older with acute HFrEF who developed VT during hospitalization (2017-2020). Propensity score matching was performed with a caliper of 0.2 with a nearest-neighbor 1:1 ratio. We then analyzed the in-hospital outcomes among those who received VT ablation vs. those without. Results: Among 47,424 acute HFrEF patients with VT, 414 (0.9%) underwent VT ablation, and 47,010 (99.1%) did not. After propensity score matching, those with VT ablation had a significantly higher rate of discharge to home (76.0% vs. 69.3%, p50.03) and a trend towards a decrease in early mortality rate (10.7% vs. 15.0%, p50.06). They had higher rates of prolonged index hospital stay (65.4% vs. 46.2%, p,0.01) and a comparable 30-day readmission rate (17.2% vs. 16.7%, p50.85). Multivariate analysis showed that chronic kidney disease (CKD) (aOR 2.0, p50.05) and pulmonary hypertension (aOR 2.5, p50.02) were independent predictors of early death among those with VT ablation. In-hospital complication rates were similar between the two groups (cardiac arrest [6.5% vs. 8.8%, p50.21], cardiogenic shock [25.7% vs. 20.4%, p50.07], acute kidney injury [45.3 vs. 41.5%, p50.28], cerebral infarction [1.7% vs. 0.5%, p50.10], and pulmonary edema [1.2% vs. 2.5%, p50.18]). Conclusion: Despite being associated with prolonged hospitalization, catheter ablation led to a higher rate of discharge to the home. CKD and pulmonary hypertension were independent predictors of early death after VT ablation for patients with acute HFrEF.
Volume
21
Issue
5S
First Page
S136
Recommended Citation
Yeo YH, San BJ, Tan MC, Ang QX, Haines DE, Bloomingdale RJ, et al. Impact of ventricular tachycardia ablation on acute heart failure with reduced ejection fraction. Heart Rhythm. 2024 May;21(5S):S136. doi: 10.1016/j.hrthm.2024.03.529
DOI
10.1016/j.hrthm.2024.03.529
Comments
Heart Rhythm Society Annual Meeting, May 16-19, 2024, Boston, MA