APCU25OS13 VT ablation and its short-term outcomes

Introduction Ventricular tachycardia (VT) can occur in patients with structural heart disease (ischemic or non-ischemic cardiomyopathy) or in those with structurally normal hearts (idiopathic VT). Catheter ablation is a treatment option to reduce VT burden and decrease ICD shocks in patients with VT secondary to structural heart disease. It may also potentially cure certain forms of idiopathic VT. The objective of this study was to analyze the acute procedural success rate (defined as non-inducibility of VT at the end of the procedure) and the 1-month all-cause mortality of patients who underwent VT ablation in our center, and to compare our results with real-world data.Methods A retrospective analysis was conducted on patients who underwent VT ablation between January 2024 and July 2025 (1 year and 7 months) in the Cardiology Department, Hospital Sultanah Bahiyah, Alor Setar. The primary endpoints were acute procedural success and 1-month all-cause mortality. Additional endpoints included complications, reduction of ICD shock therapy, ejection fraction (EF), early recurrence rate, and association with diabetes mellitus (DM).Results A total of 10 cases were analyzed. Two were idiopathic VT (fascicular VT), while eight were VT associated with ischemic or non-ischemic cardiomyopathy. Patient age ranged from 19 to 79 years (mean: 60.2 years). Acute procedural success was achieved in all cases (100%). One patient (10%) experienced 1-month all-cause mortality and one complication (cardiac tamponade, 10%), which occurred in the same individual. The deceased patient had non-ischemic cardiomyopathy, the lowest ejection fraction, and diabetes. Six out of the 10 patients had ICDs (60%), and all of them (100%) experienced a reduction in ICD shock therapy following ablation. None of the patients experienced early VT recurrence within 1 month (0%).Discussion We compared our outcomes with published meta-analysis data: acute procedural success was 100% versus 94.2%, 1-month all-cause mortality was 10% versus 6.8%, complication rate was 10% versus 6.2%, and early recurrence was 0% versus 19%. Predictors of poorer outcomes were consistent with prior studies, including older age, diabetes, and lower ejection fraction. Although the sample size was small, the findings remain informative and align with real-world data.Conclusion VT ablation remains an effective therapy, with favorable short-term outcomes. However, it is not yet routinely performed in our country due to its complexity and the need for specialized expertise. We hope the procedure will become more widely available in the near future, as ablating ventricular tachycardia reduces the risk of sudden cardiac death and improves outcomes in patients with ICD electrical storms.