Impact of ventricular tachycardia ablation in S-ICD recipients: insights from the multicenter iSUSI registry

Abstract Funding Acknowledgements Type of funding sources: None. Background The recent PARTITA trial showed a net clinical benefit early ventricular tachycardia (VT) ablation in patients with implantable cardioverter defibrillator (ICD) experiencing appropriate shocks. analysis, however, was performed transvenous ICD recipients and data regarding its generalizability subcutaneous (S-ICD) are lacking. Purpose To test whether VT after an shock or hospitalization for slow impacts long-term outcomes S-ICD recipients. Methods All (index event) the multicenter, international, physician-initiated, real-world iSUSI (International SubcutaneouS Implantable Cardioverter Defibrillator) registry were included study. Time zero set as time first / hospitalization. Patients stratified based on performance index event (VTA+ vs VTA- cohorts). primary outcome combination device-related shocks, VTs, cardiovascular mortality during follow-up. Secondary VTs mortality, taken individually. Results Among 1701 enrolled registry, n=211 this study (n=178 shocks; n=33 VTs). After event, n=58 (27.5%) underwent cohort). No significant differences baseline characteristics between VTA+ cohorts observed: mean age 47.3±16.0 years (VTA+) 47.9±17.0 (VTA-), p=0.799; males 82.8% 82.4% p=0.945; LVEF 43.8±13.2% 42.3±15.5% p=0.530; underlying ischemic cardiomyopathy 31.0% 32.7% p=0.8.19; prevention implant 36.2% 43.4% p=0.434; median number shocks at n=2 [1-4] [1-3] p=0.590. Over follow-up 17.3 [10.4–34.8] months, combined experienced by 46 (21.8%) (Figure 1). associated significantly lower rates (8.6% 26.8%; HR 0.215 [CI 0.100–0.637]; p=0.004), although only trend towards significance observed (HR 0.168 0.020–1.252]; p=0.081). ablation, cardiomyopathy, which resulted univariate remained interest multivariate analysis 0.264 0.104-0.672], p=0.005) Survival plotted using Kaplan Meier curves has been reported Figure 2. Conclusions In real world recipients, post hospitalizations improved arrhythmic