Ventricular Tachycardia Ablation Outcomes in Patients With Previous Implantable Cardioverter‐Defibrillator Insertion: A Multicenter Cohort Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Catheter ablation is increasingly used in patients with ventricular tachycardia (VT) and an implantable cardioverter-defibrillator (ICD) device in situ, but its real-world safety and effectiveness remain underexplored in this high-risk population. We aim to evaluate in-hospital outcomes associated with catheter ablation in VT patients with a history of ICD implantation using a large, nationally representative dataset. METHODS: We performed a retrospective cohort study using the National Inpatient Sample (2016-2021) to identify adult hospitalizations with VT and prior ICD device insertion. Patients were stratified into ablation and non-ablation groups. Propensity score matching was used to balance baseline characteristics. Primary outcome was in-hospital mortality; secondary outcomes included acute heart failure, ST-elevation myocardial infarction (STEMI), sepsis, major adverse cardiac events (MACE), and procedure-related complications. RESULTS: Among 395,290 hospitalizations with VT and prior ICD, 4.9% underwent ablation. Catheter ablation remained independently associated with reduced in-hospital mortality (adjusted odds ratio [aOR] = 0.59; 95% CI: 0.48-0.74), acute heart failure (aOR = 0.59; 95% CI: 0.54-0.64), ST-elevation MI (aOR = 0.44; 95% CI: 0.36-0.54), and sepsis (aOR = 0.34; 95% CI: 0.26-0.45) (all p < 0.001). The composite MACE outcome also showed a reduced odds ratio for ablation (aOR = 0.76; 95% CI: 0.68-0.85; p < 0.001). However, ablation was also associated with higher odds of cardiac tamponade (aOR = 8.33; 95% CI: 5.92-11.73), cardiogenic shock (aOR = 1.36; 95% CI: 1.19-1.55), need for mechanical circulatory support (aOR = 5.36; 95% CI: 4.63-6.21), and prolonged hospital stay ≥ 7 days (aOR = 1.69; 95% CI: 1.57-1.82) (all p < 0.001). CONCLUSION: In patients with VT and prior ICD implantation, catheter ablation is associated with improved in-hospital outcomes but higher procedural risks. These findings support its selective use in experienced centers capable of managing complications.
DOI: 10.1111/jce.70273
Institutions: West Virginia University, University of Baghdad, Community Health Systems - Northwest Health - Porter, Guthrie Robert Packer Hospital, An-Najah National University, Liaquat National Hospital, The Royal Melbourne Hospital, The University of Texas Medical Branch at Galveston, Freeman Hospital, Imperial College London, Newcastle University, Royal College of Surgeons in Ireland
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7126081073