Effect of exercise-based cardiac rehabilitation on ventricular tachycardia ablation outcomes

Exercise-based cardiac rehabilitation (CR) has shown improved outcomes in patients with cardiovascular disease. However, the effect of CR on clinical outcomes in patients who undergo ventricular tachycardia (VT) ablation has not been evaluated.

To determine the effect of exercise-based cardiac rehabilitation on clinical outcomes in patients following VT ablation.

A retrospective cohort study was conducted using the TriNetX Analytics Network database – Research Network. Patients aged >18 with a diagnosis of VT that underwent VT ablation from January 1, 2014 to December 31, 2020, identified by ICD-10 codes and Current Procedural Terminology, were included. Patients who underwent VT ablation and exercise-based CR were 1:1 propensity-score matched (PSM) to patients that had VT ablation without exercise-based CR. PSM included age, self-identified gender and race, ischemic heart disease, heart failure, cardiomyopathy, cerebrovascular disease, atrial fibrillation/flutter, hypertension, atherosclerosis, diabetes mellitus, chronic kidney disease, left ventricular ejection fraction, corrected QT interval, body mass index, and medications. Outcomes included 2-year mortality, hospitalization, antiarrhythmic use, and need for redo ablation.

Of 8,246 patients with VT that underwent VT ablation, 156 also completed exercise-based CR within 6-months of their procedure. After PSM, 154 pairs of patients were analyzed. Exercise-based CR was associated with significantly lower risk of hospitalization (Hazard Ratio [HR] 0.68, 95% Confidence Interval [CI] 0.50-0.93, p=0.02) and need for antiarrhythmic use (HR 0.76, 95% CI 0.59-0.99, p=0.04). No significant difference in risk of mortality or redo ablation were identified.

Exercise-based cardiac rehabilitation following VT ablation was associated with significantly lower risk of hospitalization and need for antiarrhythmic use at 2-year follow-up.