title: Mortality prediction using a modified Seattle Heart Failure Model may improve patient selection for ventricular tachycardia ablation.
abstract: BACKGROUND
  Catheter ablation is frequently used as a palliative option to reduce shock burden in patients with ventricular tachycardia (VT). A risk prediction tool that accurately predicts short-term survival could improve patient selection for VT ablation.
  
  
  OBJECTIVE
  The objective of the study is to assess utility of the Seattle Heart Failure Model (SHFM) to predict 6-month mortality in patients undergoing VT ablation.
  
  
  METHODS
  Data on patients who underwent VT ablation at 2 tertiary institutions were retrospectively compiled. The SHFM score at the time of ablation, including 2 added VT variables, was used to predict 6-month mortality. The predicted number of deaths was compared to the observed number to assess model calibration. Model discrimination of those who died within 6 months was assessed by both K- and C-statistics.
  
  
  RESULTS
  Mean age of the 243 patients was 63 ± 12 years; 89% were male. Mean SHFM score for the cohort was 1.3 ± 1.3. The Kaplan-Meier probability of death within 6 months was 14% (34 patients). The number of deaths estimated by the SHFM at 6 months was 31 (13%) giving a predicted to observed ratio of 0.91 (95% CI 0.64-1.30). The K-statistic for 6-month mortality predictions was 0.77 (95% CI 0.73-0.81), whereas the C-statistic was 0.84 (95% CI 0.78-0.92). Patients with an SHFM score ≥4.0 had an estimated positive predictive value of 80% (95% CI 28%-99%) for dying within 6 months of VT ablation.
  
  
  CONCLUSIONS
  The SHFM was well calibrated to a sample of patients who underwent VT ablation and provided good discrimination of short-term deaths. This model could be useful as a prognostic tool to improve patient selection for VT ablation.
authors.affiliation: Division of Cardiology, University of Minnesota, Minneapolis, MN; Division of Cardiology, Veterans Affairs Health Care System, Minneapolis, MN. Electronic address: vakil012@umn.edu.
authors.forename: Kairav P
authors.initials: KP
authors.lastname: Vakil
authors.affiliation: Division of Cardiology, University of Minnesota, Minneapolis, MN.
authors.forename: Henri
authors.initials: H
authors.lastname: Roukoz
authors.affiliation: Division of Cardiology, University of California, Los Angeles, CA.
authors.forename: Roderick
authors.initials: R
authors.lastname: Tung
authors.affiliation: Division of Cardiology, University of Washington, Seattle, WA.
authors.forename: Wayne C
authors.initials: WC
authors.lastname: Levy
authors.affiliation: Division of Cardiology, University of Minnesota, Minneapolis, MN; Division of Cardiology, Veterans Affairs Health Care System, Minneapolis, MN.
authors.forename: Inder S
authors.initials: IS
authors.lastname: Anand
authors.affiliation: Division of Cardiology, University of California, Los Angeles, CA.
authors.forename: Kalyanam
authors.initials: K
authors.lastname: Shivkumar
authors.affiliation: Center for Chronic Disease Outcomes Research, Veterans Affairs Health Care System and Department of Medicine, University of Minnesota, Minneapolis, MN.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Rector
authors.affiliation: Division of Cardiology, University of California, Los Angeles, CA.
authors.forename: Marmar
authors.initials: M
authors.lastname: Vaseghi
authors.affiliation: Division of Cardiology, University of Minnesota, Minneapolis, MN; Division of Cardiology, Veterans Affairs Health Care System, Minneapolis, MN.
authors.forename: Venkatakrishna
authors.initials: V
authors.lastname: Tholakanahalli
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D012107:Research Design; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D014481:United States / Q000453:epidemiology