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The following is a summary of “Long-term outcome after multiple VT ablations in NICM patients,” published in the April 2025 issue of Clinical Research in Cardiology by Mueller et al. 

Researchers conducted a retrospective study to compare the acute and long-term outcomes of ventricular tachycardia (VT) ablation across various non-ischemic cardiomyopathies (NICM).   

They included consecutive individuals with NICM and sustained VTs who underwent VT ablation between May 2016 and February 2022 in a large single-center study. The cohort was stratified based on the type of NICM. Outcomes assessed included VT recurrences and cardiovascular mortality.  

The results showed that 206 individuals underwent 323 VT ablations (mean age 59 ± 16 years; 81% male; left ventricular ejection fraction [LVEF] 36 ± 14%). Distribution of NICM included dilative cardiomyopathy [DCM] (57%), myocarditis (26%), sarcoidosis (8%), and arrhythmogenic right ventricular tachycardia [ARVC] (9%). Acute procedural success was highest in ARVC (90%) and lowest in DCM (74%). In-hospital VT recurrences occurred in 17% (clinical VTs in 4%) with no variation across NICM types. At discharge, DCM showed the highest antiarrhythmic drug use (41%), while ARVC had the lowest (11%). During an average follow-up of 38 ± 22 months, long-term VT recurrences were most frequent in DCM (61%), followed by myocarditis (56%), ARVC (41%), and sarcoidosis (35%) [log-rank P= 0.148]. Clinical VT recurrences occurred in 5%. A second procedure was performed in 52 individuals (51%), with 50% experiencing VT recurrence, highest in DCM [log-rank P= 0.259]. Third, fourth, fifth, and sixth ablations were performed in 20, 15, 6, and 1 individual(s), respectively. Freedom from VT after multiple procedures was 57% in DCM, 74% in myocarditis, 71% in sarcoidosis, and 82% in ARVC [log-rank P= 0.067]. Cardiovascular mortality was 19%, highest in DCM [log-rank P= 0.001].  

Investigators concluded that VT ablation in patients with NICM was highly effective in achieving rhythm control in approximately two-thirds of patients, but non-clinical VT recurrences were frequent, particularly in patients with DCM, who exhibited the highest cardiovascular mortality. 

Source: link.springer.com/article/10.1007/s00392-025-02649-w