Electrophysiological Predictors of Transplantation and Left Ventricular Assist Device-Free Survival in Patients With Nonischemic Cardiomyopathy Undergoing Ventricular Tachycardia Ablation

JACC. Clinical Electrophysiology
David S FrankelFrancis E Marchlinski

Abstract

This study sought to identify predictors of transplantation/left ventricular assist device (LVAD)-free survival among patients with left ventricular nonischemic cardiomyopathy (NICM) and ventricular tachycardia (VT). Outcomes vary widely among these patients. The derivation cohort consisted of patients with NICM undergoing VT ablation from 2007 to 2011. Scar percentage was defined as the area of low voltage divided by total surface area. Cox proportional hazard modeling was performed to identify predictors of shorter time to the primary endpoint of death, transplantation, or LVAD. A risk score was created using β regression coefficients. The risk score was then validated in a separate cohort of patients undergoing ablation from 2004 to 2007. Of 100 patients with NICM undergoing VT ablation, 41 experienced an endpoint during 1.2 years mean follow-up. In multivariate modeling, VT storm, wider native QRS duration, greater endocardial/epicardial bipolar scar percentage, and lower left ventricular ejection fraction (LVEF) identified worse transplantation/LVAD-free survival. The risk score = (VT storm × 83) + (greater of endocardial/epicardial bipolar scar percentage × 4) + (QRS duration) - (LVEF × 3). A score >180 identified patient...Continue Reading

References

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Apr 29, 2015·Journal of the American College of Cardiology·Miki YokokawaFrank M Bogun

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Citations

Jul 15, 2017·World Journal of Cardiology·Daniele MuserJackson J Liang
Jan 8, 2019·Journal of Cardiovascular Electrophysiology·Victor BazanFrancis E Marchlinski
Jul 27, 2017·Pacing and Clinical Electrophysiology : PACE·Daniele MuserPasquale Santangeli

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