Studio osservazionale Studio comparativo dei risultati dell'ablazione transcatetere di tachicardia ventricolare di differenti eziologie

Background. The aim of this study was to assess long-term results and adverse events in patients with ventricular tachycardia from different etiologies. Methods. The recurrence rate of tachycardia, consequent further therapies (other catheter ablation procedures, drug therapy and implantable defibrillator) and clinical events have been assessed in 60 consecutive patients undergoing ventricular tachycardia catheter ablation between January 2000 and December 2004. Results. During a median follow-up of 20 months (interquartile range 13-36 months), tachycardia recurred in 27 patients (45%) after a median of 3 months (interquartile range 1-12 months). A second procedure was performed in 11 patients; it was successful in 8 patients. Four patients underwent pharmacological therapy which was successful in all cases. Overall, after ablation (≥ 1 procedures) and pharmacological therapy, tachycardia was cured in 75% of cases. All the 20 patients without structural heart disease were cured with ablation vs 62% of patients with heart disease (p = 0.001). Patients with dilated cardiomyopathy reported worst results (33% success, p = 0.03). Recurrences were predicted by acute failure of procedure (p = 0.05), presence of heart disease (p = 0.006) and history of atrial arrhythmias (p = 0.02). On a multivariate analysis, only structural heart disease continued to be an independent predictor of ventricular tachycardia recurrence. Conclusions. Catheter ablation of ventricular tachycardia has a high percentage of recurrences in patients with heart disease, whereas is curative in subjects without structural heart disease.