title: Can ventricular tachycardia non-inducibility after ablation predict reduced ventricular tachycardia recurrence and mortality in patients with non-ischemic cardiomyopathy? A meta-analysis of twenty-four observational studies.
abstract: BACKGROUND
  At present, the role of ventricular tachycardia (VT) non-inducibility after ablation in patients with non-ischemic cardiomyopathy (NICM) remains controversial. We conducted a meta-analysis of the published literature to assess whether VT non-inducibility after ablation could predict reduced VT recurrence and mortality in patients with NICM.
  
  
  METHODS
  PubMed, ScienceDirect, and the Cochrane library were searched for studies evaluating the effects of VT non-inducibility after catheter ablation on the long-term outcome in NICM patients with sustained VT. Results were analyzed using a fixed-effect model, and the data were pooled using RevMan 5.3 software.
  
  
  RESULTS
  Twenty-four observational studies were identified (736 participants, mean follow-up time: 22months). NICM patients with VT inducibility after ablation had a higher risk of VT recurrence (odds ratio [OR]=5.83, 95% confidence interval [CI] 4.07-8.37; P<0.00001) and all-cause mortality (OR=3.55, 95% CI 1.62-7.78; P=0.002) compared with VT non-inducibility. Similarly in the subgroup analysis, patients with VT inducibility showed a higher risk of VT recurrence from non-ischemic dilated cardiomyopathy (OR=3.92, 95% CI 2.36-6.50; P<0.00001) and arrhythmogenic right ventricular dysplasia/cardiomyopathy (OR=5.37, 95% CI 2.20-13.10; P=0.0002). Additionally, meta-analysis also showed that combined endo-epicardial ablation significantly reduced the risk of VT recurrence compared with endocardial-only ablation (OR=2.02, 95% CI 1.19-3.44; P=0.009; mean follow-up time: 22months).
  
  
  CONCLUSIONS
  Recent evidence has shown that VT non-inducibility after ablation is a predictor for reduced VT recurrence and mortality compared with VT inducibility in NICM patients with sustained VT. In addition, endocardial plus adjuvant epicardial ablation provides better long-term arrhythmia-free survival than endocardial ablation alone.
authors: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
authors: Jinzhu
authors: J
authors: Hu
authors: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
authors: Shan
authors: S
authors: Zeng
authors: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
authors: Qiongqiong
authors: Q
authors: Zhou
authors: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
authors: Wengen
authors: W
authors: Zhu
authors: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
authors: Zhenyan
authors: Z
authors: Xu
authors: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China.
authors: Jianhua
authors: J
authors: Yu
authors: Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China; Jiangxi Key Laboratory of Molecular Medicine, Nanchang 330006, China. Electronic address: hongkui88@163.com.
authors: Kui
authors: K
authors: Hong
mesh_terms: D009202:Cardiomyopathies / Q000453:epidemiology* / Q000209:etiology; D017115:Catheter Ablation / Q000379:methods*; D056149:Epicardial Mapping; D014943:Global Health; D006801:Humans; D015994:Incidence; D012008:Recurrence; D015996:Survival Rate / Q000639:trends; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*
keywords: Ablation; Cardiomyopathy; Mortality; Recurrence; Ventricular tachycardia