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Catheter ablation of ventricular tachycardia in nonischemic heart disease
- Source :
- Circulation. Arrhythmia and electrophysiology. 5(5)
- Publication Year :
- 2012
-
Abstract
- Background— Catheter ablation of ventricular tachycardia (VT) in nonischemic heart diseases can be challenging, and outcomes across different diseases are incompletely defined. The aim of this study was to describe the outcomes after catheter ablation for nonischemic VT in a large cohort and to compare the electrophysiological findings and outcomes according to the type of underlying disease. Methods and Results— Of the 891 consecutive patients undergoing catheter ablation for ventricular arrhythmias, 226 patients (52±14 years; 79% men) with sustained VT due to nonischemic heart disease were included. The primary end point was all-cause death or heart transplantation. Secondary end points were a composite of death, heart transplantation, or readmission because of VT recurrence within 1 year of discharge. Underlying heart diseases were dilated cardiomyopathy in 119 (53%), valvular heart disease in 34 (15%), arrhythmogenic right ventricular cardiomyopathy in 37 (16%), congenital heart disease in 16 (7%), cardiac sarcoidosis in 13 (6%), and hypertrophic cardiomyopathy in 7 (3%) patients. After ablation, inability to induce any VT was achieved in 55%, and another 20% had inducible VTs modified. Major complications occurred in 5%. Arrhythmogenic right ventricular cardiomyopathy had better outcomes than dilated cardiomyopathy for primary ( P =0.002) and secondary end points ( P =0.004). Sarcoidosis had worse outcome than dilated cardiomyopathy for secondary end point ( P =0.002). At 1 year after the last ablation (a mean of 1.4±0.6 procedures, 1–4), freedom from death, heart transplantation, and readmission for VT recurrence were achieved in 173 (77%) patients. Conclusions— In patients with recurrent VT due to nonischemic heart disease, catheter ablation is often useful, although the outcome varies according to the nature of the underlying heart disease.
- Subjects :
- Adult
Male
medicine.medical_specialty
Heart disease
medicine.medical_treatment
Cardiomyopathy
Ventricular tachycardia
Patient Readmission
Right ventricular cardiomyopathy
Statistics, Nonparametric
Recurrence
Physiology (medical)
Internal medicine
medicine
Humans
Proportional Hazards Models
Heart transplantation
Chi-Square Distribution
business.industry
valvular heart disease
Hypertrophic cardiomyopathy
Dilated cardiomyopathy
Middle Aged
medicine.disease
Survival Analysis
Surgery
Treatment Outcome
Cardiology
Catheter Ablation
Tachycardia, Ventricular
Heart Transplantation
Female
Cardiology and Cardiovascular Medicine
business
Electrophysiologic Techniques, Cardiac
Subjects
Details
- ISSN :
- 19413084
- Volume :
- 5
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Circulation. Arrhythmia and electrophysiology
- Accession number :
- edsair.doi.dedup.....b64140f17f09acd1b454f1a74fe86271