title: Freedom from recurrent ventricular tachycardia after catheter ablation is associated with improved survival in patients with structural heart disease: An International VT Ablation Center Collaborative Group study.
abstract: BACKGROUND
  The impact of catheter ablation of ventricular tachycardia (VT) on all-cause mortality remains unknown.
  
  
  OBJECTIVE
  The purpose of this study was to examine the association between VT recurrence after ablation and survival in patients with scar-related VT.
  
  
  METHODS
  Analysis of 2061 patients with structural heart disease referred for catheter ablation of scar-related VT from 12 international centers was performed. Data on clinical and procedural variables, VT recurrence, and mortality were analyzed. Kaplan-Meier analysis was used to estimate freedom from recurrent VT, transplant, and death. Cox proportional hazards frailty models were used to analyze the effect of risk factors on VT recurrence and mortality.
  
  
  RESULTS
  One-year freedom from VT recurrence was 70% (72% in ischemic and 68% in nonischemic cardiomyopathy). Fifty-seven patients (3%) underwent cardiac transplantation, and 216 (10%) died during follow-up. At 1 year, the estimated rate of transplant and/or mortality was 15% (same for ischemic and nonischemic cardiomyopathy). Transplant-free survival was significantly higher in patients without VT recurrence than in those with recurrence (90% vs 71%, P<.001). In multivariable analysis, recurrence of VT after ablation showed the highest risk for transplant and/or mortality [hazard ratio 6.9 (95% CI 5.3-9.0), P<.001]. In patients with ejection fraction <30% and across all New York Heart Association functional classes, improved transplant-free survival was seen in those without VT recurrence.
  
  
  CONCLUSIONS
  Catheter ablation of VT in patients with structural heart disease results in 70% freedom from VT recurrence, with an overall transplant and/or mortality rate of 15% at 1 year. Freedom from VT recurrence is associated with improved transplant-free survival, independent of heart failure severity.
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, Los Angeles, California.
authors.forename: Roderick
authors.initials: R
authors.lastname: Tung
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, Los Angeles, California.
authors.forename: Marmar
authors.initials: M
authors.lastname: Vaseghi
authors.affiliation: Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: David S
authors.initials: DS
authors.lastname: Frankel
authors.affiliation: Hospital San Raffaele, Milan, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Vergara
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nagashima
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, Los Angeles, California.
authors.forename: Ricky
authors.initials: R
authors.lastname: Yu
authors.affiliation: UCLA Department of Medicine Statistics Core, Los Angeles, California.
authors.forename: Sitaram
authors.initials: S
authors.lastname: Vangala
authors.affiliation: UCLA Department of Medicine Statistics Core, Los Angeles, California.
authors.forename: Chi-Hong
authors.initials: CH
authors.lastname: Tseng
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Eue-Keun
authors.initials: EK
authors.lastname: Choi
authors.affiliation: Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Shaan
authors.initials: S
authors.lastname: Khurshid
authors.affiliation: Baylor St. Luke's Medical Center/Texas Heart Institute, Houston, Texas.
authors.forename: Mehul
authors.initials: M
authors.lastname: Patel
authors.affiliation: Baylor St. Luke's Medical Center/Texas Heart Institute, Houston, Texas.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Mathuria
authors.affiliation: Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Nakahara
authors.affiliation: University of Colorado, Aurora, Colorado.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Tzou
authors.affiliation: University of Colorado, Aurora, Colorado.
authors.forename: William H
authors.initials: WH
authors.lastname: Sauer
authors.affiliation: University of Minnesota Medical Center, Minneapolis VA Medical Center, Minneapolis, Minnesota.
authors.forename: Kairav
authors.initials: K
authors.lastname: Vakil
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Usha
authors.initials: U
authors.lastname: Tedrow
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: J David
authors.initials: JD
authors.lastname: Burkhardt
authors.affiliation: University of Minnesota Medical Center, Minneapolis VA Medical Center, Minneapolis, Minnesota.
authors.forename: Venkatakrishna N
authors.initials: VN
authors.lastname: Tholakanahalli
authors.affiliation: University of Maryland Medical Center, Baltimore, Maryland.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Saliaris
authors.affiliation: University of Maryland Medical Center, Baltimore, Maryland.
authors.forename: Timm
authors.initials: T
authors.lastname: Dickfeld
authors.affiliation: Intermountain Heart Institute, Intermountain Medical Center, Murray, Utah.
authors.forename: J Peter
authors.initials: JP
authors.lastname: Weiss
authors.affiliation: Intermountain Heart Institute, Intermountain Medical Center, Murray, Utah.
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
authors.affiliation: University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Madhu
authors.initials: M
authors.lastname: Reddy
authors.affiliation: University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Arun
authors.initials: A
authors.lastname: Kanmanthareddy
authors.affiliation: Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: David J
authors.initials: DJ
authors.lastname: Callans
authors.affiliation: University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas.
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
authors.affiliation: Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Francis
authors.initials: F
authors.lastname: Marchlinski
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: William G
authors.initials: WG
authors.lastname: Stevenson
authors.affiliation: Hospital San Raffaele, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Della Bella
authors.affiliation: UCLA Cardiac Arrhythmia Center, UCLA Health System, Los Angeles, California. Electronic address: kshivkumar@mednet.ucla.edu.
authors.forename: Kalyanam
authors.initials: K
authors.lastname: Shivkumar
mesh_terms: D000368:Aged; D018780:Body Surface Potential Mapping; D009202:Cardiomyopathies / Q000150:complications* / Q000401:mortality / Q000628:therapy; D017115:Catheter Ablation; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D017180:Tachycardia, Ventricular / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014481:United States / Q000453:epidemiology
keywords: Ablation; Ventricular tachycardia