Impact of Phenotype on Recurrence of VT Post-Ablation in Patients With Nonischemic Cardiomyopathy.
Shreyas Singireddy, Sami Shoura, Darshine Venugopal et al.
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In 30 seconds
This systematic review and meta-analysis examined whether ventricular tachycardia (VT) recurrence after ablation differs among six nonischemic cardiomyopathy phenotypes. Across 18 studies involving 1699 patients, recurrence varied significantly by phenotype (F [5,12] = 3.78, p = 0.027), from 82.6% in lamin A/C cardiomyopathy to 33.8% in arrhythmogenic right ventricular cardiomyopathy. Phenotype accounted for 44.7% of between-study heterogeneity. The findings suggest that grouping nonischemic cardiomyopathies together may obscure clinically relevant differences in post-ablation outcomes.
Key findings
- VT recurrence differed significantly across phenotypes (F [5,12] = 3.78, p = 0.027).
- Recurrence was highest in lamin A/C cardiomyopathy at 82.6% (95% CI 51.6%-95.5%; k = 5).
- Recurrence was lowest in arrhythmogenic right ventricular cardiomyopathy at 33.8% (16.0%-57.9%; k = 3).
- Phenotype explained 44.7% of between-study heterogeneity.
Why it matters
The range of reported recurrence rates indicates that nonischemic cardiomyopathy is not a uniform context for VT ablation outcomes. Recognising phenotype-related variation may help frame outcome estimates and supports stratifying future studies by underlying disease rather than pooling these conditions.
What to keep in mind
The analysis pooled results from only 18 studies, with some phenotypes represented by two studies. The authors describe the findings as hypothesis-generating and call for validation in prospective registries.