Arrhythmias & electrophysiologyResearch article
Determinants of recurrence after epicardial ventricular tachycardia ablation in structural heart disease
- Epicardial ventricular tachycardia (VT) ablation in structural heart disease (SHD)
Authors' conclusion
Combined endocardial and epicardial VT ablation in advanced SHD was associated with moderate acute success, whereas VT recurrence remained common during follow-up. Electrical storm, longer VT cycle length, and higher body mass index were independently associated with an increased risk of recurrence.
Study context
- Population
- Patients with structural heart disease undergoing epicardial ventricular tachycardia ablationpatients with SHD undergoing epicardial VT ablation
- Participants
- 74 patients
Main finding
As reported in the abstract
Acute procedural noninducibility
Noninducibility achieved
49 patients (66%)
Further findings
Determinants of VT recurrence (cause-specific Cox analysis)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| electrical storm · independently associated with VT recurrence | 3.130 (1.421–6.893) | P = 0.005 | |
| longer VT cycle length · independently associated with VT recurrence | 2.835 (1.211–6.638) | P = 0.016 | |
| higher body mass index · independently associated with VT recurrence | 2.918 (1.365–6.236) | P = 0.006 | |
| 0.10.31310Hazard ratio (log scale) |
VT recurrence · follow-up of 17 months
- VT recurrence
- 37 patients (50%)
Etiology and scar distribution
- Nonischemic cardiomyopathy was the predominant etiology
- Epicardial scar predominantly involved basal-lateral left ventricular regions with periannular and outflow tract extension
Safety
Adverse clinical events during follow-up
- died
- 7 patients
- underwent heart transplantation
- 10
- required ventricular assist device implantation
- 2
Original publication
Determinants of recurrence after epicardial ventricular tachycardia ablation in structural heart disease. Heart Rhythm. Published 20 April 2026. doi:10.1016/j.hrthm.2026.04.026
Summarised from the published abstract; every number is checked against it