title: Catheter ablation of scar-based ventricular tachycardia: Relationship of procedure duration to outcomes and hospital mortality.
abstract: BACKGROUND
  Ablation has become an important option for treatment of ventricular tachycardia (VT). The influence of procedure duration on outcomes remains unexamined.
  
  
  OBJECTIVE
  The purpose of this study was to determine the influence of procedure duration on outcomes and complications over an 8-year period
  
  
  METHODS
  Patients referred for scar-mediated VT ablation from 2004 to 2011 were retrospectively analyzed. Procedure duration was defined as the time from the insertion of catheters through the femoral vein to the time of their withdrawal. Procedure duration was analyzed in relationship with baseline and intraoperative covariates, acute procedural outcomes, complications, and 6-month clinical outcomes.
  
  
  RESULTS
  One hundred forty-eight patients underwent VT ablation with mean procedure duration of 5.7 ± 1.8 hours. VT recurrence and survival at 6 months were 46% and 82%, respectively, and were not associated with procedure duration. Hospital mortality increased with intraoperative intraaortic balloon pump insertion (adjusted odds ratio [OR] 13.7, 95% confidence interval [CI] 2.35-79.94, P = .004) and was improved with successful ablation of the clinical VT as a procedural end-point (adjusted OR 0.13, 95% Cl 0.03-0.54, P = .005). The association between procedure duration and hospital mortality remained after adjusting for significant baseline variables (adjusted OR 1.75, 95% CI 1.14-2.68, P = .0098) and intraoperative variables (adjusted OR 1.6, 95% CI 1.12-2.29, P = .0104).
  
  
  CONCLUSIONS
  Hospital mortality was significantly increased by unsuccessful clinical VT ablation as a procedural end-point and intraoperative intraaortic balloon pump insertion. However, after adjusting for significant baseline and intraoperative covariates, procedure duration still was associated with increased hospital mortality. Procedure duration had no impact on VT recurrence and survival at 6 months.
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Ricky
authors.initials: R
authors.lastname: Yu
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Sootkeng
authors.initials: S
authors.lastname: Ma
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Roderick
authors.initials: R
authors.lastname: Tung
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Steven
authors.initials: S
authors.lastname: Stevens
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Carlos
authors.initials: C
authors.lastname: Macias
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Jason
authors.initials: J
authors.lastname: Bradfield
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Eric
authors.initials: E
authors.lastname: Buch
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Marmar
authors.initials: M
authors.lastname: Vaseghi
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Osama
authors.initials: O
authors.lastname: Fujimura
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gornbein
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Ravi
authors.initials: R
authors.lastname: Mandapati
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California.
authors.forename: Kalyanam
authors.initials: K
authors.lastname: Shivkumar
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, David Geffen School of Medicine at UCLA, Los Angeles, California. Electronic address: nboyle@mednet.ucla.edu.
authors.forename: Noel G
authors.initials: NG
authors.lastname: Boyle
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D002921:Cicatrix / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
keywords: Hospital mortality; Procedure duration; Ventricular tachycardia; Ventricular tachycardia ablation; Ventricular tachycardia ablation efficacy; Ventricular tachycardia recurrence