Echocardiographic predictors of survival in patients undergoing radiofrequency ablation of postinfarct clinical ventricular tachycardia.
BACKGROUND
The aim of this study was to determine the predictive value of echocardiographic parameters of systolic left ventricular (LV) dysfunction for survival in a group of patients with "mappable" ventricular tachycardia (VT) after myocardial infarction who underwent radiofrequency ablation (RFA) of their clinical VT(s).


RESULTS
RFA of at least one inducible, "mappable," and clinical VT was attempted in 61 patients. In total, 63 (79%) of 80 target clinical VTs were ablated successfully, such that clinical VT(s) were noninducible in 49 (80%) of 61 patients. At the last recorded follow-up (range 2 to 98 months; mean 21 +/- 20), nonfatal VT recurrences were observed in 11 (22%) patients; 10 (16%) patients died. On univariate analysis, a higher LV end-diastolic volume (LVEDV; P = 0.008) and, by multivariate analysis, applying backward selection of variables, older age (P = 0.03) with a higher LVEDV (P = 0.003) predicted patients more likely to die. When age and LV ejection fraction (LVEF) were excluded, LV end-systolic diameter (LVESD; P = 0.007) was the most significant predictor of survival.


CONCLUSIONS
In our patient population with postinfarct VT who underwent RFA of mappable clinical VT(s), LVEF did not predict survival. In this group of patients with overall low mean LVEF (<35%), older age together with higher LVEDV and LVESD predicted patients who were more prone to die. LV size rather than LVEF correlated with survival.
Nabar
Ashish
A
Department of Cardiology, Academic Hospital Maastricht, The Netherlands.
Rodriguez
Luz-Maria
LM
Batra
Ravinder Kumar
RK
Timmermans
Carl
C
Cheriex
Emile
E
Wellens
Hein J J
HJ
D000368:Aged; D000375:Aging / Q000502:physiology; D017115:Catheter Ablation; D004452:Echocardiography; D004562:Electrocardiography; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D013534:Survival; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*