Ishiwata Mai, Kanaoka Koshiro, Tonegawa-Kuji Reina, Sumita Yoko, Nakamura Toshihiro, Oka Satoshi, Miyazaki Yuichiro, Wakamiya Akinori, Ueda Nobuhiko, Nakajima Kenzaburo, Kamakura Tsukasa, Wada Mitsuru, Ishibashi Kohei, Inoue Yuko, Miyamoto Koji, Kusano Kengo, Aiba Takeshi
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Osaka Japan.
Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center Osaka Japan.
Circ Rep. 2025 Jul 16;7(9):756-763. doi: 10.1253/circrep.CR-25-0037. eCollection 2025 Sep 10.
Catheter ablation (CA) for ventricular tachycardia (VT) is an effective treatment for preventing VT recurrence. However, the optimal timing and outcomes of CA for VT during emergent admission remains unclear.
We retrospectively investigated patients who underwent CA for VT after emergent admission between 2012 and 2021 using the Japanese Registry of All Cardiac and Vascular Diseases database. The clinical characteristics, complication and outcomes (primary outcome: in-hospital death; secondary outcome: emergent re-admission for VT within 30 days) were compared between the patients who underwent CA within (CA ≤3) and after (CA >3) the third day of admission. A total of 3,827 patients (787 patients had CA ≤3 days, and 3,040 patients had CA >3 days) was enrolled. Compared with the CA >3 days group, those with CA ≤3 were younger and had less comorbidities of underlying heart diseases and medications. After adjusting for baseline characteristics, CA ≤3 days or >3 days after emergent admission was not associated with in-hospital death and re-admission for VT. Furthermore, the emergent re-admission and overall complication rates were not significantly different between the 2 groups.
The clinical background differed substantially between patients who underwent CA within 3 days and those who underwent CA later during emergency hospitalization. An emergency CA for VT is not strongly recommended; however, it might be acceptable in cases with unavoidable circumstances.
导管消融术（CA）治疗室性心动过速（VT）是预防VT复发的有效方法。然而，急诊入院期间CA治疗VT的最佳时机和结果仍不明确。
我们使用日本全心血管疾病注册数据库，回顾性调查了2012年至2021年间急诊入院后接受CA治疗VT的患者。比较入院后第三天内（CA≤3）和第三天后（CA>3）接受CA治疗的患者的临床特征、并发症和结果（主要结果：住院死亡；次要结果：30天内因VT再次急诊入院）。共纳入3827例患者（787例患者CA≤3天，3040例患者CA>3天）。与CA>3天组相比，CA≤3天组患者更年轻，潜在心脏病和药物治疗的合并症更少。在调整基线特征后，急诊入院后CA≤3天或>3天与住院死亡和因VT再次入院无关。此外，两组的急诊再次入院率和总体并发症发生率无显著差异。
急诊住院3天内接受CA治疗的患者与之后接受CA治疗的患者的临床背景存在显著差异。不强烈推荐对VT进行急诊CA治疗；然而，在不可避免的情况下可能是可以接受的。
