title: Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: results from the Prospective Heart Centre of Leipzig VT (HELP-VT) Study.
abstract: BACKGROUND
  Data on the outcomes of ventricular tachycardia (VT) ablation in nonischemic dilated cardiomyopathy (NIDCM) are insufficient. The Heart Center of Leipzig VT (HELP-VT) study was conducted prospectively to compare outcomes after radiofrequency catheter ablation of VT in patients with NIDCM compared with ischemic cardiomyopathy (ICM).
  
  
  RESULTS
  Two hundred twenty-seven patients, 63 with NIDCM and 164 with ICM, presenting with sustained VT were ablated with radiofrequency catheter ablation. Noninducibility of any clinical and nonclinical VT was achieved in 66.7% of NIDCM and in 77.4% of ICM patients. Ablation of the clinical VT only was achieved in 18.3% of ICM and in 22.2% of NIDCM patients. There was no statistically significant difference in short-term outcomes between the 2 groups. At the 1-year follow-up, VT-free survival in NIDCM was 40.5% compared with 57% in ICM. In univariate analysis, the hazard ratio for VT recurrence was significantly higher for NIDCM (1.62; 95% confidence interval, 1.12- 2.34; P=0.01). In both the ICM and NIDCM subgroups, procedure failure and incomplete procedural success were independent predictors of VT recurrence.
  
  
  CONCLUSIONS
  Although the short-term success rates after VT ablation in NIDCM and ICM patients were similar, the long-term outcomes in NIDCM patients were significantly worse. Complete VT noninducibility at the end of the ablation is associated with beneficial long-term outcome in NIDCM. Pursuing compete elimination of all inducible VTs is desirable and may improve the long-term success in NIDCM.
authors.affiliation: Department of Electrophysiology, Heart Centre, University of Leipzig, Leipzig, Germany.
authors.forename: Borislav
authors.initials: B
authors.lastname: Dinov
authors.forename: Lukas
authors.initials: L
authors.lastname: Fiedler
authors.forename: Robert
authors.initials: R
authors.lastname: Schönbauer
authors.forename: Andreas
authors.initials: A
authors.lastname: Bollmann
authors.forename: Sascha
authors.initials: S
authors.lastname: Rolf
authors.forename: Christopher
authors.initials: C
authors.lastname: Piorkowski
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
mesh_terms: D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000401:mortality / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
keywords: cardiomyopathy, dilated; catheter ablation; outcome assessment (health care)