Real-world characteristics and management of ventricular tachycardias in ICD patients: Data from the VIDEO registry
摘要
While VT ablation is increasingly recognized as effective, its real-world efficacy, risks, and outcomes require further investigation. This study aims to assess VT ablations in a real-world scenario using data from the German VIDEO registry.
MethodsWe analyzed 801 ICD patients hospitalized with VT within the German VIDEO registry between 2018 and 2023. Among these, 145 patients (18%) underwent VT ablation. Characteristics and in-hospital outcomes were compared between patients with and without ablation.
ResultsPatients (mean age 63 ± 14 years, 19% female) selected for VT ablation had fewer comorbidities. The ablation group had lower rates of diabetes mellitus (16.6% vs. 24.7%, p = 0.04), chronic kidney disease (11.0% vs. 25.0%, p < 0.01), and ischemic heart disease (55.9% vs. 68.1%, p < 0.01). In-hospital outcomes differed between groups, with fewer ICU admissions (39.3% vs. 55.5%, p < 0.01) and less need for mechanical ventilation (11.0% vs. 20.1%, p = 0.01) in the ablation group. Additionally, the ablation group experienced fewer serious arrhythmic events, including lower rates of ventricular fibrillation (8.3% vs. 17.2%, p < 0.01) and cardiac arrest (9.7% vs. 19.1%, p < 0.01) while in-hospital mortality did not differ significantly.
ConclusionIn this real-world registry, about 20% of VT patients underwent catheter ablation. Patients undergoing ablation had fewer comorbidities, indicating substantial selection. Observed differences in in-hospital outcomes likely reflect the combination of patient selection for ablation and treatment effects.
Graphical abstract