Complication rates following ventricular tachycardia ablation in ischaemic and non-ischaemic cardiomyopathies: a systematic review.



Ding, Wern Yew ORCID: 0000-0003-3596-6545, Pearman, Charles M, Bonnett, Laura ORCID: 0000-0002-6981-9212, Adlan, Ahmed, Chin, Shui Hao, Denham, Nathan, Modi, Simon, Todd, Derick, Hall, Mark CS and Mahida, Saagar
(2021) Complication rates following ventricular tachycardia ablation in ischaemic and non-ischaemic cardiomyopathies: a systematic review. Journal of Interventional Cardiac Electrophysiology: an international journal of arrhythmias and pacing.

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Abstract

<h4>Background</h4>Catheter ablation of ventricular tachycardia (VT) is associated with potential major complications, including mortality. The risk of acute complications in patients with ischaemic cardiomyopathy (ICM) and non-ischaemic cardiomyopathy (NICM) has not been systematically evaluated.<h4>Methods</h4>PubMed was searched for studies of catheter ablation of VT published between September 2009 and September 2019. Pre-specified primary outcomes were (1) rate of major acute complications, including death, and (2) mortality rate.<h4>Results</h4>A total of 7395 references were evaluated for relevance. From this, 50 studies with a total of 3833 patients undergoing 4319 VT ablation procedures fulfilled the inclusion criteria (mean age 59 years; male 82%; 2363 [62%] ICM; 1470 [38%] NICM). The overall major complication rate in ICM cohorts was 9.4% (95% CI, 8.1-10.7) and NICM cohorts was 7.1% (95% CI, 6.0-8.3). Reported complication rates were highly variable between studies (ICM I<sup>2</sup> = 90%; NICM I<sup>2</sup> = 89%). Vascular complications (ICM 2.5% [95% CI, 1.9-3.1]; NICM 1.2% [95% CI, 0.7-1.7]) and cerebrovascular events (ICM 0.5% [95% CI, 0.2-0.7]; NICM, 0.1% [95% CI, 0-0.2]) were significantly higher in ICM cohorts. Acute mortality rates in the ICM and NICM cohorts were low (ICM 0.9% [95% CI, 0.5-1.3]; NICM 0.6% [95% CI, 0.3-1.0]) with the majority of overall deaths (ICM 75%; NICM 80%) due to either recurrent VT or cardiogenic shock.<h4>Conclusion</h4>Overall acute complication rates of VT ablation are comparable between ICM and NICM patients. However, the pattern and predictors of complications vary depending on the underlying cardiomyopathy.

Item Type: Article
Depositing User: Symplectic Admin
Date Deposited: 11 Feb 2021 10:37
Last Modified: 26 Jul 2021 11:11
DOI: 10.1007/s10840-021-00948-6
Open Access URL: https://doi.org/10.1007/s10840-021-00948-6
URI: https://livrepository.liverpool.ac.uk/id/eprint/3115484