In-hospital outcomes of catheter ablation for ventricular tachycardia in patients with prior coronary artery bypass grafting

Department

Internal Medicine

Additional Department

Cardiology

Document Type

Article

Publication Title

Heart Rhythm O2

Abstract

Background: Catheter ablation is an established therapy for recurrent ventricular tachycardia (VT). However, outcomes in patients with prior coronary artery bypass grafting (CABG) remain poorly defined.

Objective: This study aimed to evaluate in-hospital outcomes following VT ablation in patients with and without a history of CABG.

Methods: We used the National Inpatient Sample database (2008-2022) to identify adults with a primary diagnosis of VT who underwent ablation. Patients were stratified by prior CABG status. Propensity score weighting (PSW) was applied to adjust for baseline characteristics. The primary outcome was in-hospital mortality. Secondary outcomes included procedural complications and measures of health care utilization. A subgroup analysis was performed for patients with coronary artery disease (CAD).

Results: Among 35,860 patients undergoing VT ablation, 18.2% had a history of CABG. After PSW, in-hospital mortality was similar between CABG and non-CABG groups (2.0% vs 2.3%, P = 0.771). Prior CABG was associated with higher rates of cardiac arrest (2.2% vs 1.1%, P = 0.03) and acute myocardial infarction (AMI) (5.2% vs 2.7%, P = 0.014), but lower rates of pericardial complications (0.9% vs 7.3%, P < 0.001). In the CAD subgroup, the association between CABG and AMI was attenuated and trended toward a higher incidence in the CABG group.

Conclusion: In this national cohort, prior CABG was not associated with increased in-hospital mortality or major complications after VT ablation. Patients who underwent CABG experienced higher rates of AMI and cardiac arrest but fewer pericardial complications. In a CAD- subgroup, the AMI association was attenuated and trended in the same direction.

First Page

109

Last Page

118

DOI

10.1016/j.hroo.2025.09.001

Volume

7

Issue

1

Publication Date

1-1-2026

PubMed ID

41695504

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