PO-04-189 CLINICAL OUTCOMES OF VENTRICULAR TACHYCARDIA ABLATION IN CARDIAC SARCOIDOSIS

Abstract

Cardiac sarcoidosis (CS) is a known cause of ventricular tachycardia (VT) and sudden death. CS-related ventricular tachycardia (VT) is a rare disorder, and the underlying substrate and response to ablation are poorly understood. We aimed to assess clinical outcomes after catheter ablation for VT in CS patients. The meta-analysis was performed using a meta-package for R version 4.0/RStudio version 1.2, and Freeman Tukey double arcsine transformation with Hartung-Knapp random effect model was used. Outcomes measured included – (1) acute procedure success (defined as non-inducible for any VT); (2) freedom from recurrent VT; (3) redo VT ablation; (4) procedure-related complication; and (5) all-cause mortality. Eight studies from 2006 to 2021 incorporating a total of 273 patients with CS with drug-refractory VT underwent VT ablation (67% were men, mean age 50.3 ± 11.4 years, mean left ventricular ejection fraction 43.3 ± 15.3%). 83% had inducible VT with a mean inducible VT per patient of 2.9 ± 2.6. 14.7% of patients underwent epicardial-endocardial ablation, while the rest underwent endocardial-only ablation. Overall, acute procedural success was 73.7% (95% CI 45-95.1), with a procedure-related complication rate of 4.7% (95% CI 2.6-7.2). During the follow-up period (3.3±3.4 years), the pooled incidence of freedom from recurrent VT was 46.4% (95% CI 26.9–66.5), while 27.1% (95% CI 16.9-38.5) underwent redo VT ablation. All-cause mortality was 8.1% (95% CI 3.3-14.2). Catheter ablation of VT in conjunction with antiarrhythmic drugs in CS patients is safe and effective in eliminating VT or reducing the VT burden; however, recurrences are common, probably due to the inflammatory disease phase.