Impact of race on outcomes from catheter ablation of ventricular tachycardia in structural heart disease: A prospective registry from south metropolitan Chicago

Nathan W Kong; Dalise Y Shatz; Stephanie A Besser; Gaurav A Upadhyay; Roderick Tung

doi:10.1016/j.hroo.2023.01.007

Impact of race on outcomes from catheter ablation of ventricular tachycardia in structural heart disease: A prospective registry from south metropolitan Chicago

Heart Rhythm O2. 2023 Jan 31;4(3):215-222. doi: 10.1016/j.hroo.2023.01.007. eCollection 2023 Mar.

Authors

Nathan W Kong¹, Dalise Y Shatz², Stephanie A Besser², Gaurav A Upadhyay², Roderick Tung²

Affiliations

¹ Department of Internal Medicine, University of Chicago, Chicago, Illinois.
² Center for Arrhythmia Care, Pritzker School of Medicine, University of Chicago, Chicago, Illinois.

Abstract

Background: Whether racial disparities in outcomes are present after catheter ablation for scar-related ventricular tachycardia (VT) is not known.

Objective: The purpose of this study was to examine whether racial differences exist in outcomes for patients undergoing VT ablation.

Methods: From March 2016 through April 2021, consecutive patients undergoing catheter ablation for scar-related VT at the University of Chicago were prospectively enrolled. The primary outcome was VT recurrence, with secondary outcome of mortality alone and composite endpoint of left ventricular assist device placement, heart transplant, or mortality.

Results: A total of 258 patients were analyzed: 58 (22%) self-identified as Black, and 113 (44%) had ischemic cardiomyopathy. Black patients had significantly higher rates of hypertension (HTN), chronic kidney disease (CKD), and VT storm at presentation. At 7 months, Black patients experienced higher rates of VT recurrence (P = .009). However, after multivariable adjustment, there were no observed differences in VT recurrence (adjusted hazard ratio [aHR] 1.65; 95% confidence interval [CI] 0.91-2.97; P = .10), all-cause mortality (aHR 0.49; 95% CI 0.21-1.17; P = .11), or composite events (aHR 0.76; 95% CI 0.37-1.54; P = .44) between Black and non-Black patients.

Conclusion: In this diverse prospective registry of patients undergoing catheter ablation for scar-related VT, Black patients experienced higher rates of VT recurrence compared to non-Black patients. When adjusted for highly prevalent HTN, CKD, and VT storm, Black patients had comparable outcomes as non-Black patients.

Keywords: Catheter ablation; Health care disparities; Prospective registry; Race; Ventricular tachycardia.