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Background  Ventricular tachycardia ( VT ) causes significant morbidity and mortality. Implantable cardioverter‐defibrillator shocks terminate  VT  but confer a significant morbidity and mortality risk. Therefore,  VT  ablation is increasingly common. Patients with structural heart disease ( SHD ) and patients with structurally normal hearts as well as the subgroup with and without ischemic heart disease were assessed for predictors of mortality and nonfatal  VT  recurrence. We present the first multicenter, prospective German  VT  registry.    Methods and Results  In 334 patients, 118 structurally normal hearts and 216  SHD  (74.5% ischemic heart disease), referred for  VT  ablation in 38 centers, long‐term follow‐up was assessed for a minimum of 12 months and analyzed for factors predicting  VT  recurrence rates and mortality. The  VT s in  SHD  patients were more frequently hemodynamically unstable (34.7% versus 12.7%,  P <0.0001) or incessant (9.7% versus 2.7%,  P <0.05). More  SHD  patients underwent substrate modification than patients with structurally normal hearts who had more focal ablations. Ablation failure was 9% in both groups. Two‐year mortality was higher in patients with  SHD  (18.7% versus 3.5%,  P <0.001). Predictors of mortality include age >60 years, incessant  VT , left ventricular ejection fraction ≤30%, procedural failure, and Class I and  III  anti‐arrhythmic drug use at discharge. Only procedural failure is a predictor of nonfatal  VT  recurrence.    Conclusions  Procedural failure was the sole independent predictor for nonfatal  VT  recurrence for our study cohort. This emphasizes the importance of a successful ablation procedure in experienced hands to reduce long‐term mortality and nonfatal  VT  recurrence.

journal of the american heart association

Ablation Outcomes and Predictors of Mortality Following Catheter Ablation for Ventricular Tachycardia: Data From the German Multicenter Ablation Registry