title: Early referral for ablation of scar-related ventricular tachycardia is associated with improved acute and long-term outcomes: results from the Heart Center of Leipzig ventricular tachycardia registry.
abstract: BACKGROUND
  The effects of time to referral for catheter ablation (CA) of scar-related ventricular tachycardia (VT) on acute success, VT recurrence, and cardiac mortality are unclear.
  
  
  RESULTS
  We investigated 300 patients after CA of sustained VT. CA was performed within 30 days after the first documented VT in 75 (25%) patients (group 1), between 1 month and 1 year in 84 (28%) patients (group 2), and >1 year after the first VT occurrence in 141 (47%) patients (group 3). The end points were noninducibility of any VT after CA (acute success), VT recurrence and cardiac mortality after 2 years. Acute success was achieved in 66 (88%) patients in group 1, 68 (81%) in group 2, and in 99 (70.2%) in group 3 (P=0.008). During the 2-year follow-up period, VT recurred in 28 (37.3%) patients in group 1, 52 (61.9%) patients in group 2, and 91 (64.5%) patients in group 3 (P<0.0001). Recurrence-free survival was higher in group 1, as compared with group 2 (hazard ratio [HR], 1.85; P=0.009) and group 3 (HR, 2.04; P=0.001). No survival difference was observed between groups 1 and 2 (HR, 0.85; P=0.68) and groups 1 and 3 (HR, 1.13; P=0.73). β-blocker therapy, VT of ischemic origin, and complete success were associated with VT-free survival. VT recurrence (HR, 1.91; P=0.037) predicted cardiac mortality.
  
  
  CONCLUSIONS
  CA of scar-related VT performed within 30 days after the first documented VT was associated with improved acute and long-term success. VT recurrence, but not the early referral for CA, was associated with cardiovascular mortality.
authors.affiliation: From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany. dinov@gmx.de.
authors.forename: Borislav
authors.initials: B
authors.lastname: Dinov
authors.affiliation: From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
authors.affiliation: From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Livio
authors.initials: L
authors.lastname: Bertagnolli
authors.affiliation: From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Valentina
authors.initials: V
authors.lastname: Schirripa
authors.affiliation: From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Schoene
authors.affiliation: From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Sommer
authors.affiliation: From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bollmann
authors.affiliation: From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Sascha
authors.initials: S
authors.lastname: Rolf
authors.affiliation: From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
mesh_terms: D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D002921:Cicatrix / Q000175:diagnosis / Q000209:etiology*; D018572:Disease-Free Survival; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D009206:Myocardium / Q000473:pathology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012008:Recurrence; D012017:Referral and Consultation; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: catheter ablation; tachycardia, ventricular