Abstract 16742: Early Recurrence of Ventricular Tachycardia is Associated With Greater One-Year Mortality Among Patients With Severe Heart Failure

Abstract

Background: Ventricular tachycardia (VT) is common in patients with severe heart failure (HF). Objective: We sought to determine whether early recurrence of VT is associated with worse survival. Methods: We performed retrospective analysis of patients presenting to a tertiary referral hospital between 2006-2017 with VT and severe HF (defined as New York Heart Association functional Class IV or any Interagency Registry for Mechanically Assisted Circulatory Support score) for whom electrophysiology consultation was requested. A comparison was made in baseline characteristics and outcomes between those with early VT recurrence (within 30 days of initial consult) and those without early VT recurrence. Results: Of 129 patients, 47% underwent ablation while 53% were managed medically. Mean age was 60±12 years, 84% were males, ischemic cardiomyopathy was present in 55%, mean LVEF was 24±12%, and 77% had a preexisting ICD. Early recurrence of VT was observed in 25 patients (19%). Those with early recurrence had lower mean LVEF (20±7% vs 25±12%, p =0.032), were less likely to have an ICD prior to presentation (56% vs 82%, p =0.015), were more likely to have been treated with only medications (80% vs 20%, p =0.003), had greater in-hospital mortality (28% vs 5%, p =0.002) and experienced a longer hospitalization (23±19 vs 17±16 days), compared to those without early recurrence. There was no significant difference in other baseline characteristics between groups. Patients with early recurrence had significantly worse 1-year survival 56% vs 82% (Figure), with OR 3.5, 95% CI [1.3,8.9]. Conclusion: Early VT recurrence among patients with severe heart failure is associated with increased mortality within the year following presentation. VT ablation should be considered to help mitigate risk of early recurrence and associated morbidity in such patients.