Background: Ventricular tachycardia (VT) recurrence after catheter ablation remains
a concern, emphasizing the need for precise risk assessment. We aimed to use machine
learning (ML) to predict 1-month and 1-year VT recurrence following VT ablation. Methods:
For 337 patients undergoing VT ablation, we collected 31 parameters including medical
history, echocardiography, and procedural data. 17 relevant features were included
in the ML-based feature selection, which yielded six and five optimal features for
1-month and 1-year recurrence, respectively. We trained several supervised machine
learning models using 10-fold cross-validation for each endpoint. Results: We observed
1-month VT recurrence was observed in 60 (18%) cases and accurately predicted using
our model with an area under the receiver operating curve (AUC) of 0.73. Input features
used were hemodynamic instability, incessant VT, ICD shock, left ventricular ejection
fraction, TAPSE, and non-inducibility of the clinical VT at the end of the procedure.
A separate model was trained for 1-year VT recurrence (observed in 117 (35%) cases)
with a mean AUC of 0.71. Selected features were hemodynamic instability, the number
of inducible VT morphologies, left ventricular systolic diameter, mitral regurgitation,
and ICD shock. For both endpoints, a random forest model displayed the highest performance.
Conclusions: Our ML models effectively predict VT recurrence post-ablation, aiding
in identifying high-risk patients and tailoring follow-up strategies.
