title: Catheter ablation of ventricular tachycardia in nonischemic heart disease.
abstract: BACKGROUND
  Catheter ablation of ventricular tachycardia (VT) in nonischemic heart diseases can be challenging, and outcomes across different diseases are incompletely defined. The aim of this study was to describe the outcomes after catheter ablation for nonischemic VT in a large cohort and to compare the electrophysiological findings and outcomes according to the type of underlying disease.
  
  
  RESULTS
  Of the 891 consecutive patients undergoing catheter ablation for ventricular arrhythmias, 226 patients (52 ± 14 years; 79% men) with sustained VT due to nonischemic heart disease were included. The primary end point was all-cause death or heart transplantation. Secondary end points were a composite of death, heart transplantation, or readmission because of VT recurrence within 1 year of discharge. Underlying heart diseases were dilated cardiomyopathy in 119 (53%), valvular heart disease in 34 (15%), arrhythmogenic right ventricular cardiomyopathy in 37 (16%), congenital heart disease in 16 (7%), cardiac sarcoidosis in 13 (6%), and hypertrophic cardiomyopathy in 7 (3%) patients. After ablation, inability to induce any VT was achieved in 55%, and another 20% had inducible VTs modified. Major complications occurred in 5%. Arrhythmogenic right ventricular cardiomyopathy had better outcomes than dilated cardiomyopathy for primary (P=0.002) and secondary end points (P=0.004). Sarcoidosis had worse outcome than dilated cardiomyopathy for secondary end point (P=0.002). At 1 year after the last ablation (a mean of 1.4 ± 0.6 procedures, 1-4), freedom from death, heart transplantation, and readmission for VT recurrence were achieved in 173 (77%) patients.
  
  
  CONCLUSIONS
  In patients with recurrent VT due to nonischemic heart disease, catheter ablation is often useful, although the outcome varies according to the nature of the underlying heart disease.
authors.affiliation: Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. tokudam@gmail.com
authors.forename: Michifumi
authors.initials: M
authors.lastname: Tokuda
authors.forename: Usha B
authors.initials: UB
authors.lastname: Tedrow
authors.forename: Pipin
authors.initials: P
authors.lastname: Kojodjojo
authors.forename: Keiichi
authors.initials: K
authors.lastname: Inada
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Koplan
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Michaud
authors.forename: Roy M
authors.initials: RM
authors.lastname: John
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Epstein
authors.forename: William G
authors.initials: WG
authors.lastname: Stevenson
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012008:Recurrence; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome