Arrhythmias & electrophysiologyCohort study
Periprocedural acute haemodynamic decompensation during substrate-based ablation of scar-related ventricular tachycardia: a rare and unpredictable event
- Retrospective cohort study
- single-centre registry
- validation of the PAINESD score
Complications collected via institutional registry and adjudicated using source medical records
Authors' conclusion
Primarily substrate-based CA of SHD-related VT performed under conscious sedation is associated with a substantially lower rate of AHD than previously reported. The PAINESD score did not predict these events.
Study context
- Population
- Patients undergoing first radiofrequency catheter ablation for structural heart disease-related ventricular tachycardia (VT), mainly under conscious sedation, 2006–2020
- Participants
- 1,124 patients
- Exposure
- PAINESD score terciles for prediction of acute haemodynamic decompensation (AHD)
- Outcome
- Acute haemodynamic decompensation (AHD): acute pulmonary oedema or refractory hypotension requiring urgent intervention
- Follow-up
- Intraprocedural or early post-procedural (<12 h)
Main finding
As reported in the abstract
AHD
PAINESD <9
0.3
%
PAINESD 9-14
1.8
%
PAINESD >14
1.1%
- Overall AHD rate
- 13/1124 = 1.2%
Observational data: associations, not effects.
Further findings
PAINESD score
- PAINESD score, mean ± SD
- 11.4 ± 6.6
- PAINESD score, median (IQR)
- 12 (6-17)
Mortality during follow-up
- PAINESD score strongly predicted mortality during follow-up
Original publication
Periprocedural acute haemodynamic decompensation during substrate-based ablation of scar-related ventricular tachycardia: a rare and unpredictable event. Europace. Published 12 June 2024. doi:10.1093/europace/euae145
Summarised from the published abstract; every number is checked against it