• Borislav Dinov, Arash Arya, Livio Bertagnolli, Valentina Schirripa, Katharina Schoene, Philipp Sommer, Andreas Bollmann, Sascha Rolf, and Gerhard Hindricks.
• From the Department of Cardiac Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany. dinov@gmx.de.
• Circ Arrhythm Electrophysiol. 2014 Dec 1; 7 (6): 1144-51.

BackgroundThe effects of time to referral for catheter ablation (CA) of scar-related ventricular tachycardia (VT) on acute success, VT recurrence, and cardiac mortality are unclear.Methods And ResultsWe investigated 300 patients after CA of sustained VT. CA was performed within 30 days after the first documented VT in 75 (25%) patients (group 1), between 1 month and 1 year in 84 (28%) patients (group 2), and >1 year after the first VT occurrence in 141 (47%) patients (group 3). The end points were noninducibility of any VT after CA (acute success), VT recurrence and cardiac mortality after 2 years. Acute success was achieved in 66 (88%) patients in group 1, 68 (81%) in group 2, and in 99 (70.2%) in group 3 (P=0.008). During the 2-year follow-up period, VT recurred in 28 (37.3%) patients in group 1, 52 (61.9%) patients in group 2, and 91 (64.5%) patients in group 3 (P<0.0001). Recurrence-free survival was higher in group 1, as compared with group 2 (hazard ratio [HR], 1.85; P=0.009) and group 3 (HR, 2.04; P=0.001). No survival difference was observed between groups 1 and 2 (HR, 0.85; P=0.68) and groups 1 and 3 (HR, 1.13; P=0.73). β-blocker therapy, VT of ischemic origin, and complete success were associated with VT-free survival. VT recurrence (HR, 1.91; P=0.037) predicted cardiac mortality.ConclusionsCA of scar-related VT performed within 30 days after the first documented VT was associated with improved acute and long-term success. VT recurrence, but not the early referral for CA, was associated with cardiovascular mortality.© 2014 American Heart Association, Inc.

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