Impact of catheter ablation for ventricular tachycardia on left ventricular ejection fraction in patients with structural heart disease

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Arrhythmia Pub Date : 2025-03-17 DOI:10.1002/joa3.70042

Ashish Sood MBBS, Samual Turnbull BSc, Kasun De Silva MBBS, Ashwin Bhaskaran MBBS, MSc (Int Med), Richard G. Bennett BSc, MBChB, PhD, Timothy G. Campbell BSc, PhD, Liza Thomas MBBS, PhD, Saurabh Kumar MBBS, PhD

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Abstract

Background

Catheter ablation (CA) is efficacious for the treatment of ventricular tachycardia (VT) in patients with structural heart disease; however, heart failure contributes to long-term mortality in this cohort. Whether CA worsens left ventricular function requires investigation.

Methods

We retrospectively analyzed 142 consecutive patients with structural heart disease undergoing CA for VT. Pre-ablation left ventricular ejection fraction (LVEF) was compared to LVEF postablation, predictors of change in LVEF were identified, and the relationship between change in LVEF and arrhythmic recurrence was assessed.

Results

Patients with ischemic cardiomyopathy (ICM) had lower pre-ablation LVEF than patients with non-ischemic cardiomyopathy (NICM) (36.2 ± 14.3% vs. 50.8 ± 12.8%, p < 0.001). There was no statistically significant change in LVEF following ablation for patients with ICM (p = 0.45) or NICM (p = 0.75). Patients with pre-ablation LVEF ≤20% experienced the largest recovery in LVEF, mean recovery 5.3% (95% CI: 0.6–10.1), p = 0.03, with LVEF recovery postablation similar in ICM and NICM patients (p = 0.69). Recovery of LVEF was associated with a decreased incidence of ventricular arrhythmia (VA) recurrence (p = 0.03) and an increased VA-recurrence-free survival (p = 0.04).

Conclusion

CA for VT does not cause a decline in LVEF among patients with structural heart disease. The subset of patients with severely impaired LVEF may experience an increase in LVEF following ablation and an associated reduction in VA recurrence.

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导管消融治疗室性心动过速对结构性心脏病患者左室射血分数的影响

背景：导管消融（CA）治疗结构性心脏病患者室性心动过速（VT）有效；然而，在这个队列中，心力衰竭会导致长期死亡率。CA是否恶化左心室功能还需进一步研究。方法回顾性分析142例连续接受房颤治疗的结构性心脏病患者。将消融前左室射血分数（LVEF）与消融后的LVEF进行比较，确定LVEF变化的预测因素，并评估LVEF变化与心律失常复发的关系。结果缺血性心肌病（ICM）患者消融前LVEF低于非缺血性心肌病（NICM）患者（36.2±14.3%∶50.8±12.8%,p < 0.001）。ICM和NICM患者消融后LVEF变化无统计学意义（p = 0.45）或（p = 0.75）。术前LVEF≤20%的患者LVEF恢复最大，平均恢复5.3% (95% CI: 0.6-10.1), p = 0.03， ICM和NICM患者消融后LVEF恢复相似（p = 0.69）。LVEF的恢复与室性心律失常（VA）复发发生率的降低（p = 0.03）和室性心律失常无复发生存率的增加（p = 0.04）相关。结论房颤不引起结构性心脏病患者LVEF下降。LVEF严重受损的患者亚群可能经历LVEF在消融后增加和相关的VA复发减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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