Non-Induciblity in Post Infarction VT as an End Point for VT Ablation and its Effects on Outcomes: A Meta-Analysis
Background—Although ventricular tachycardia (VT) ablation is a widely used therapy for patients with VT, the ideal endpoints for this procedure are not well defined. We performed a meta-analysis of the published literature to assess the predictive value of non-inducibility of post-infarction VT for long-term outcomes after VT ablation.
Methods and Results—We performed a systematic review of MEDLINE (1950-2013), EMBASE (1988-2013), the Cochrane Controlled Trials Register (Fourth Quarter, 2012) and reports presented at scientific meetings (1994-2013). Randomized controlled trials, case control, and cohort studies of VT ablation were included. Outcomes reported in eligible studies were freedom from VT/VF and all-cause mortality. Of 3895 studies evaluated, we identified 8 cohort studies enrolling 928 patients for the meta-analysis. Non-inducibility after VT ablation was associated with a significant increase in arrhythmia free survival when compared with partial success (OR, 0.49; 95% CI, 0.29-0.84; p=0.009) or failed ablation procedure (OR, 0.10; 95% CI, 0.06-0.18; p<0.001). There was also a significant reduction in all-cause mortality if patients were non-inducible after VT ablation compared to patients with partial success (OR, 0.59; 95% CI, 0.36-0.98; p=0.04) or failed ablation (OR, 0.32; 95% CI, 0.10-0.99; p=0.049).
Conclusions—Non-inducibility of VT after VT ablation is associated with improved arrhythmia free survival and all-cause mortality.
- Received August 5, 2013.
- Revision received April 23, 2014.
- Accepted May 1, 2014.