Procedure related complications
Overall complications rate was 11.3% without significant differences
among groups (11.1% for group 1, 17% for group 2 and 7.9% for group
3, p=0.251)(table 2). Complications included: 4 cardiac tamponades
requiring pericardiocentesis, 3 arterial pseudoaneurysms (2 requiring
surgical correction) and 1 femoral hematoma not requiring further
interventions. Finally 1 patient died after an acute coronary oclussion
(proximal LAD) during the procedure which was inmediately stented but
resulting in refractary cardiogenic shock.
Only 9 patients (5.6%) had an acute hemodynamic decompensation during
or after the VT ablation procedure. Baseline mean PAINSDD score was
10.7±6.7 (<10: 48.8%, 10-16: 31.2% and ≥17: 20%). There was
no relationship between acute hemodynamic decompensation and activation
mapping. In patients with inducible VT (groups 2 and 3), only 1/50
patients (2%) with activation mapping developed acute hemodynamic
decompensation in comparison with 6/92 patients with VT inducibility but
no activation mapping, p=0.421. The incidence of acute hemodynamic
decompensation depending on the PAINSDD score was as follows: 6.4% for
PAISDD < 10.2% for PAINSDD 10-16, and 9.4% for PAINSDD ≥17,
p=0.337. None of group 1 patients had acute hemodynamic decompensation
in comparison with 7.5% of group 2 patients and 5.6% of group 3
patients, p=0.486. Of these 9 patients, 2 died due to refractary
cardiogenic shock (one of them after a ventricular assist device was
implanted during the ablation procedure) and 1 underwent cardiac
transplantation while in the rest 6 patients the hemodynamic
decompensation was managed with inotropic drugs and could be stabilized
and recovered without further complications.