In‐Hospital Outcomes of Ventricular Tachycardia Catheter Ablation in the Presence of Intra‐Cardiac Thrombus.

Background: Ventricular tachycardia (VT) catheter ablation in the presence of intracardiac thrombi was evaluated in very few studies. Objectives: To investigate in‐hospital outcomes of VT ablation in the presence of an intracardiac thrombus, in a large inpatient US registry. Methods: Using the National Inpatient Sample (NIS) database, patients who underwent non‐elective VT catheter ablations in the United States between 2016 and 2019 were identified using ICD‐10 codes. Sociodemographic, clinical data, in‐hospital procedures, and outcomes as well as in‐hospital mortality were collected. In‐hospital outcomes were compared using propensity score (PS) matching analysis with a 1:3 ratio between patients with and without intracardiac thrombus. Results: A weighted total of 15,725 admissions for non‐elective VT ablation were included in the study, of which 190 (1.2%) had a discharge diagnosis of intracardiac thrombus. Patients with intracardiac thrombus had a higher comorbidity burden and were more likely to have ischemic cardiomyopathy and a diagnosis of cardiac aneurysm. In PS analysis, the presence of intracardiac thrombus was significantly associated with higher rates of any in‐hospital complications (42.1% vs. 19.3%, p < 0.009), driven by higher periprocedural cerebrovascular accident and vascular injury events. In‐hospital mortality rates were not significantly different between the groups. Conclusions: In patients undergoing non‐elective VT ablation, intracardiac thrombus was associated with higher rates of in‐hospital complications, but not higher in‐hospital mortality. These findings suggest that intracardiac thrombus should not contraindicate VT ablation when deemed necessary, while efforts should be made to decrease potential complications. [ABSTRACT FROM AUTHOR]