TY - JOUR
T1 - Characteristics of recurrent ventricular tachyarrhythmia after catheter ablation in patients with arrhythmogenic right ventricular cardiomyopathy
AU - Lin, Chin Yu
AU - Chung, Fa Po
AU - Kuo, Ling
AU - Lin, Yenn Jiang
AU - Chang, Shih Lin
AU - Lo, Li Wei
AU - Hu, Yu Feng
AU - Tuan, Ta Chuan
AU - Chao, Tze Fan
AU - Liao, Jo Nan
AU - Chang, Ting Yung
AU - Yamada, Shinya
AU - Te, Abigail Louise D.
AU - Huang, Ting Chun
AU - Chen, Shih Ann
N1 - Funding Information:
Szu‐Yuan Research Foundation of Internal Medicine and Taipei Veterans General Hospital, Grant/Award Numbers: V105C‐122, V107C‐060, V104B‐018, V104C‐109, V107C‐ 054, V106B‐010, V106C‐158, V107B‐014, V106C‐104, V104C‐121, V105C‐116, V105B‐ 014, V104E7‐001; Research Foundation of Cardiovascular Medicine, TVGH‐NTUH Joint Research Program, Grant/Award Numbers: VGHUST104‐G7‐3‐1, VGHUST105‐G7‐4‐1, VGHUST105‐G7‐9‐1; Ministry of Science and Technology, Grant/Award Numbers: MOST 104‐2314‐B‐010‐063‐MY2, MOST 106‐2314‐ B‐075‐006‐MY3, MOST 104‐2314‐B‐075‐ 089‐MY3, MOST 106‐2314‐B‐075‐073‐MY3, MOST 106‐2314‐B‐010‐046‐MY3; Center for Dynamical Biomarkers and Translational Medicine, Ministry of Science and Technology
Funding Information:
This study was supported by the Center for Dynamical Biomarkers and Translational Medicine, Ministry of Science and Technology (Grant numbers MOST 106‐2314‐B‐075‐006‐MY3, MOST 106‐2314‐B‐010‐ 046‐MY3, MOST 106‐2314‐B‐075‐073‐MY3, MOST 104‐2314‐B‐ 010‐063‐MY2, and MOST 104‐2314‐B‐075‐089‐MY3), Research Foundation of Cardiovascular Medicine, TVGH‐NTUH Joint Research Program (Grant numbers VGHUST105‐G7‐9‐1, VGHUST105‐G7‐4‐1, and VGHUST104‐G7‐3‐1), Szu‐Yuan Research Foundation of Internal Medicine and Taipei Veterans General Hospital (Grant numbers V104B‐018, V104E7‐001, V104C‐121, V104C‐109, V105B‐014, V105C‐122, V105C‐116, V106C‐158, V106B‐010, V106C‐104, V107B‐014, V107C‐060, and V107C‐054).
Publisher Copyright:
© 2019 Wiley Periodicals, Inc.
PY - 2019/4
Y1 - 2019/4
N2 - Background: The reason for recurrence of ventricular arrhythmia (VA) after catheter ablation in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is not clear. Methods: In this study, 91 ARVC patients (age, 47 ± 13 years; 47 men) who underwent catheter ablation for drug-refractory ventricular arrhythmia (VA) were enrolled. The patients were categorized into single or multiple procedures (n = 28). The baseline characteristics and electrophysiological features of the patients were examined to elucidate the reason of the VA recurrences. Results: A total of 186 VAs were induced during the index procedure and 176 (94.6%) were eliminated. Successful, partially successful, and failed ablations were achieved in 89.0%, 8.8%, and 2.2% of the patients, respectively. During a mean follow-up period of 32 ± 26 months, 35 patients had VA recurrences. Forty-two repeat procedures were performed for 81 induced VAs in 28 patients. Of the 42 repeat procedures, successful, partially successful, and failed ablations were achieved in 37, 4, and 1 of the procedures, respectively. Most of the recurrent VAs (70 [72.9%]) originated from the newly-developed circuits owing to the scar progression. The patients with repeat procedure had worsening right ventricular remodeling. The multivariate analysis revealed that history as endurance athlete significantly predicted the need of a repeat procedure in spite of the initially successful endocardial/epicardial ablation and negative inducibility (hazard ratio: 3.014, 95% confidence interval: 1.493-6.084, P = 0.002). Conclusions: In spite of the initial complete VA elimination, history as an athlete was associated with scar progression, RV remodeling, and VA recurrences from the newly developed arrhythmogenic substrates/circuit in ARVC.
AB - Background: The reason for recurrence of ventricular arrhythmia (VA) after catheter ablation in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) is not clear. Methods: In this study, 91 ARVC patients (age, 47 ± 13 years; 47 men) who underwent catheter ablation for drug-refractory ventricular arrhythmia (VA) were enrolled. The patients were categorized into single or multiple procedures (n = 28). The baseline characteristics and electrophysiological features of the patients were examined to elucidate the reason of the VA recurrences. Results: A total of 186 VAs were induced during the index procedure and 176 (94.6%) were eliminated. Successful, partially successful, and failed ablations were achieved in 89.0%, 8.8%, and 2.2% of the patients, respectively. During a mean follow-up period of 32 ± 26 months, 35 patients had VA recurrences. Forty-two repeat procedures were performed for 81 induced VAs in 28 patients. Of the 42 repeat procedures, successful, partially successful, and failed ablations were achieved in 37, 4, and 1 of the procedures, respectively. Most of the recurrent VAs (70 [72.9%]) originated from the newly-developed circuits owing to the scar progression. The patients with repeat procedure had worsening right ventricular remodeling. The multivariate analysis revealed that history as endurance athlete significantly predicted the need of a repeat procedure in spite of the initially successful endocardial/epicardial ablation and negative inducibility (hazard ratio: 3.014, 95% confidence interval: 1.493-6.084, P = 0.002). Conclusions: In spite of the initial complete VA elimination, history as an athlete was associated with scar progression, RV remodeling, and VA recurrences from the newly developed arrhythmogenic substrates/circuit in ARVC.
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U2 - 10.1111/jce.13853
DO - 10.1111/jce.13853
M3 - Article
C2 - 30699244
AN - SCOPUS:85061058655
VL - 30
SP - 582
EP - 592
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
SN - 1045-3873
IS - 4
ER -