# Periprocedural Outcomes of VT Ablation in Ischemic Compared to Non‐Ischemic Dilated Cardiomyopathy

## TL;DR

The study compares risks and outcomes of ventricular tachycardia ablation in patients with ischemic versus non-ischemic heart disease.

## Contribution

It identifies distinct periprocedural complication patterns between ischemic and non-ischemic cardiomyopathy patients undergoing VT ablation.

## Key findings

- ICM patients had higher rates of sudden cardiac arrest and cardiogenic shock compared to NIDCM patients.
- NIDCM patients experienced more pericardial complications but similar mortality rates.
- Readmission rates were consistently higher for NIDCM patients at 30, 90, and 180 days.

## Abstract

Patients with structural heart disease undergoing catheter ablation (CA) for VT have shown higher procedural‐related adverse events. However, periprocedural outcomes comparing CA for VT in different cardiomyopathies are not well known. We aim to study short‐term outcomes of CA in ischemic (ICM) compared to non‐ischemic dilated cardiomyopathy (NIDCM).

The national readmission database (2016–2020) was used to identify hospitalizations for CA for VT. Cohorts were stratified based on underlying cardiomyopathy. A Propensity Score Matching (PSM) model matched ICM to NIDCM patients. Pearson's Chi‐squared test was applied to PSM‐matched cohorts to compare outcomes.

Among 7081 hospitalizations for VT ablation, 17.5% of patients had underlying NIDCM, while 82.5% of patients had ICM. On a PSM analysis (N: 3534), ICM patients had higher incidences of sudden cardiac arrest (SCA) (7.9% vs. 5.6%, p < 0.001), major adverse cardiac events (11.1% vs. 9%, p: 0.006), and cardiogenic shock (10.8% vs. 8.5%, p: 0.001). Interestingly, NIDCM patients were found to have much higher rates of pericardial complications (6.09% vs. 1.90%, p < 0.001), while the mortality difference was not significant (p > 0.05). From 2016 to 2020, in‐hospital mortality rates have not changed significantly in ICM and NIDCM cases admitted for VT ablation (p‐trend > 0.05); however, there was a decreasing trend of SCA cases in NIDCM hospitalizations (8.7%–3.4%, p‐trend: 0.028). NIDCM patients had higher readmission rates at 30 days (18% vs. 15.5%, p: 0.01), 90‐day (32.3% vs. 29.6%, p: 0.041), and 180‐day (44% vs. 38.2%, p: 0.001).

VT ablation in ICM patients was associated with higher non‐fatal periprocedural events. NIDCM patients showed higher all‐cause readmission rates.

VT ablation in ICM is associated with higher periprocedural adverse events except pericardial complications, which are higher in NIDCM. Created using Biorender.com. C‐shock, cardiogenic shock; ICM, ischemic cardiomyopathy; MACE, major adverse cardiovascular events; NIDCM, non‐ischemic dilated cardiomyopathy; PSM‐propensity score matching; SCA‐sudden cardiac arrest; VT, ventricular tachycardia.