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Outcomes of Catheter Ablation of Ventricular Tachycardia in Non-Ischaemic Cardiomyopathy A Systematic review and meta-analysis
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  • Ahmed Ammar,
  • Mohamed Sharief,
  • Khaled Abouelmagd,
  • Omar Riad,
  • Mokhtar Ibrahim
Ahmed Ammar
Ain Shams University

Corresponding Author:[email protected]

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Mohamed Sharief
Mansoura University
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Khaled Abouelmagd
Cardiology Department Dr Mohammad Alfagih Hospital KSA
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Omar Riad
Ain Shams University
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Mokhtar Ibrahim
Ain Shams University
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Abstract

Background: Catheter Ablation (CA) of Ventricular Tachycardia (VT) in patients with Non-Ischaemic Cardiomyopathy (NICM) is a well-known line of treatment to prevent recurrence of VT and ICD shocks.  Objective: To perform a systematic review and meta-analysis of available trials regarding the outcomes of VT ablation in patients with NICM. Methods: A comprehensive database search of large four electronic databases, including PubMed, Cochrane, Scopus, and Institute for Scientific Information network meta-analysis, identified ten studies enrolling 16370 patients for patients with NICM underwent CA for VT. The short-term outcomes assessed included procedural success, VT non-inducibility and procedural complications, whereas the long-term outcomes assessed included VT recurrence, repeat ablation procedures, heart transplantation, and death.  Results: A total of 10 observational studies reported outcomes in 16370 patients with NICM undergoing VT catheter ablation. Idiopathic dilated cardiomyopathy (IDCM) was the most frequently reported etiology of NICM (60.2%) and the duration of follow up ranged from 12 to 49 months. The complete procedural success was moderately high; 57.3% (95% CI 0.493-0.652) with VT non-inducibility observed in 63.5% of the patients (95% CI 0.434-0.836), major complications up to 6% (95% CI 0.055-0.079) and in-hospital death up to 1.5% (95% CI (0.003-0.027). The long-term outcomes showed an estimate of 44.5% for VT recurrence (95% CI 0.331-0.558), 18.2% for death (95% CI 0.123-0.559) and 7% for heart transplantation (95% CI 0.030-0.110). Conclusion: The meta-analysis showed that VT catheter ablation in NICM is safe and effective approach for management of patients with NICM and VT with wide discrepancy in the reported short and long-term outcomes after VT ablation likely because of the heterogeneous VT substrates in each etiology and the different VT ablation strategies.