title: Correlates and prognosis of early recurrence after catheter ablation for ventricular tachycardia due to structural heart disease.
abstract: BACKGROUND
  Catheter ablation for ventricular tachycardia (VT) from structural heart disease has a significant risk of recurrence, but the optimal duration for in-hospital monitoring is not defined. This study assesses the timing, correlates, and prognostic significance of early VT recurrence after ablation.
  
  
  RESULTS
  Of 370 patients (313 men; aged 63.0±13.2 years) who underwent a first radiofrequency ablation for sustained monomorphic VT associated with structural heart disease from 2008 to 2012, sustained VT recurred in 81 patients (22%) within 7 days. In multivariable analysis, early recurrence was associated with New York Heart Association classification ≥III (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.03-3.48; P=0.04), dilated cardiomyopathy (OR 1.93, 95% CI 1.03-3.57; P=0.04), prevalence of VT storm before the procedure (OR 2.62, 95% CI 1.48-4.65; P=0.001), a greater number of induced VTs (OR 1.24, 95% CI 1.07-1.45; P=0.006), and acute failure or no final induction test (OR 1.88, 95% CI 1.03-3.40; P=0.04). During a median of 2.5 (1.2, 4.0) years of follow-up, early VT recurrence was an independent correlates of mortality (hazard ratio 2.59, 95% CI 1.52-4.34; P=0.0005).
  
  
  CONCLUSIONS
  Patients who have early recurrences of VT after ablation are a high risk group who may be identifiable from their clinical profile. Further study is warranted to define the optimal treatment strategies for this patient group.
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nagashima
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Eue-Keun
authors.initials: EK
authors.lastname: Choi
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Usha B
authors.initials: UB
authors.lastname: Tedrow
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Koplan
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Michaud
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Roy M
authors.initials: RM
authors.lastname: John
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Laurence M
authors.initials: LM
authors.lastname: Epstein
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Michifumi
authors.initials: M
authors.lastname: Tokuda
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Inada
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Kaity Y
authors.initials: KY
authors.lastname: Lin
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Chirag R
authors.initials: CR
authors.lastname: Barbhaiya
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Chinitz
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Enriquez
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
authors.forename: Alan F
authors.initials: AF
authors.lastname: Helmbold
authors.affiliation: From the Arrhythmia Unit, Cardiovascular Division, Brigham and Women's Hospital, Boston, MA. wstevenson@partners.org.
authors.forename: William G
authors.initials: WG
authors.lastname: Stevenson
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017115:Catheter Ablation / Q000009:adverse effects* / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: catheter ablation; ventricular tachycardia