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

IF 2.2 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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