Abstract 18987: A 10-Year Contemporary Analysis of Outcomes of Patients With Amyloidosis and VT Underdoing Ventricular Tachycardia (VT) Ablation

Abstract

Introduction: Cardiac amyloidosis (CA) can lead to heart failure and arrhythmias as a result of electromechanical cardiac remodeling. CA is most associated with atrial fibrillation, however, small studies have shown that the highest risk population is those with ventricular tachycardia (VT). There are limited studies on the clinical implications of patients with cardiac amyloidosis and VT undergoing VT ablation (VTA) versus medical therapy. This study’s aim is to assess mortality and outcomes in patients with CA undergoing VTA vs medical therapy. Hypothesis: We anticipate CA patients undergoing VTA will have better outcomes than their medically managed counterparts. Methods: The US National Inpatient Sample (NIS) was searched for patients with CA with and without VTA as a secondary diagnosis using ICD-9/10 codes from 2010 to 2020. Primary outcomes were inpatient mortality, hospital length of stay (LOS), and total hospital charges (TOTHC). Data analysis utilized propensity matching via the Kernel Method. Results: his study included 357,350 patients with CA, of which 92,750 underwent VT ablation (Group A), which was compared with CA patients receiving medical therapy (Group B). Group A had decreased mortality (5.27% vs 11.33%, p<0.0001), but increased LOS (+6.81 days, p<0.0001, CI: 6.15-7.47), and TOTHC ($240,459.80, p<0.0001, CI: 105,536.40-375,383.30). Secondary analysis is described in Table 1. Conclusions: Although LOS and TOTHC were increased in patients with CA with VTA, overall mortality was decreased compared to those with CA managed medically. Numerous risk factors were identified that worsen hospital outcomes in this population. Our study demonstrates that early referral to EP and early VT ablation could be the best management strategy for patients with CA and VT as they had significantly reduced mortality compared to the group which only had medical management.