title: Noninducibility in postinfarction ventricular tachycardia as an end point for ventricular tachycardia ablation and its effects on outcomes: a meta-analysis.
abstract: BACKGROUND
  Although ventricular tachycardia (VT) ablation is a widely used therapy for patients with VT, the ideal end points for this procedure are not well defined. We performed a meta-analysis of the published literature to assess the predictive value of noninducibility of postinfarction VT for long-term outcomes after VT ablation.
  
  
  RESULTS
  We performed a systematic review of MEDLINE (1950-2013), EMBASE (1988-2013), the Cochrane Controlled Trials Register (Fourth Quarter, 2012), and reports presented at scientific meetings (1994-2013). Randomized controlled trials, case-control, and cohort studies of VT ablation were included. Outcomes reported in eligible studies were freedom from VT/ventricular fibrillation and all-cause mortality. Of the 3895 studies evaluated, we identified 8 cohort studies enrolling 928 patients for the meta-analysis. Noninducibility after VT ablation was associated with a significant increase in arrhythmia-free survival compared with partial success (odds ratio, 0.49; 95% confidence interval, 0.29-0.84; P=0.009) or failed ablation procedure (odds ratio, 0.10; 95% confidence interval, 0.06-0.18; P<0.001). There was also a significant reduction in all-cause mortality if patients were noninducible after VT ablation compared with patients with partial success (odds ratio, 0.59; 95% confidence interval, 0.36-0.98; P=0.04) or failed ablation (odds ratio, 0.32; 95% confidence interval, 0.10-0.99; P=0.049).
  
  
  CONCLUSIONS
  Noninducibility of VT after VT ablation is associated with improved arrhythmia-free survival and all-cause mortality.
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: Hamid
authors.initials: H
authors.lastname: Ghanbari
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: Kazim
authors.initials: K
authors.lastname: Baser
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: Miki
authors.initials: M
authors.lastname: Yokokawa
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: William
authors.initials: W
authors.lastname: Stevenson
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: Paolo
authors.initials: P
authors.lastname: Della Bella
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vergara
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: Thomas
authors.initials: T
authors.lastname: Deneke
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Kuck
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: Hans
authors.initials: H
authors.lastname: Kottkamp
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: She
authors.initials: S
authors.lastname: Fei
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.).
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
authors.affiliation: From the Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor (H.G., K.B., M.Y., F.M., F.B.); Department of Internal Medicine, Cardiovascular Division, Brigham and Women Hospital, Boston, MA (W.S.); Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy (P.D.B., P.V.); Klinik für Kardiologie II, Herz- und Gefäß-Klinik GmbH, Bad Neustadt, Germany (T.D.); Hanseatisches Herzzentrum, Asklepios Klinik St. Georg, Hamburg, Germany (K.-H.K.); Department of Electrophysiology, Klinik Hirslanden, Zürich, Switzerland (H.K.); and Department of Internal Medicine, Division of Cardiology, Peking University Third Hospital, Beijing, China (S.F.). fbogun@umich.edu.
authors.forename: Frank
authors.initials: F
authors.lastname: Bogun
mesh_terms: D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D018572:Disease-Free Survival; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: meta-analysis; tachycardia, ventricular