Introduction: Ventricular Tachycardia (VT) ablation is indicated in patients with recurrent episodes of VT or ICD shocks despite the use of antiarrhytmic drugs. We aim to evaluate the clinical characteristics and follow-up of patients that underwent scar related VT ablation in a school hospital in south america.
Methods: We collected and analyzed data of all VT ablation procedures performed in our institution between January 2013 and December 2014.
Results: During the 2 year studied period we perform 107 scar related VT ablation procedures in 86 different patients with a mean age of 56.7±14 years-old, most patients were male (70,9%). Sixty (56%) patients presented Chagas cardiomyopathy, 17 (16%) ischemic, 13 (12%) dilated idiopathic, 12 (11%) RVAD and 5 (5%) other cardiomyopathies and the mean LV ejection fraction was 36.9±12.4%. The ablation was performed with CARTO in 60 (56,1%) patients, Ensite 3 (2,8%) and electrophysiological only mapping in 44 (41,1%) procedures. Epicardial mapping was performed in 65 procedures (60,7%), being most frequent in Chagas patients (81,7%;P < 0.001). There was complications in 6 (5,6%) procedures: one hemopericardium that open-chest surgery was necessary; two iliac artery dissection, both with conservative treatment; one complete AV block; one patient with refractory hypotension with the need of IABP and procedure interruption and one patient with late cardiac tamponade with the need of surgical drainage. In a median follow-up of 261 (Q1: 93 Q3: 479) days, 42 (40%) procedures presented recurrence in a median time of 40 (Q1: 7.5 Q3: 125) days. After the VT recurrence the ablation was repeated, and one patient underwent 4 ablation, 2 three ablations and 13 underwent two ablations. Following the last ablation, 61 (72.6%) patients remained free of VT recurrence (figure). Sixteen (19%) patients died in a median time of 34 (Q1: 14.75 Q3: 93) days following last ablation.
Conclusions: Chagas disease was the most common cardiopathy in this population, where epicardial approach was frequently performed. After the last procedure, the majority of patients remained free of VT recurrence.