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Should all patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy undergo epicardial catheter ablation?
- Source :
- Journal of Interventional Cardiac Electrophysiology. 48:193-199
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- Epicardial radiofrequency catheter ablation is currently considered as the therapeutic option of choice in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) and recurrent ventricular tachycardia (VT). We hypothesised that inducibility of VT may guide the ablation strategy and thereby affect long-term results. Additional epicardial ablation was only performed if VT were still inducible after thorough endocardial ablation. The objective was to examine an inducibility-guided ablation approach by comparing the long-term results between endocardial and epi-endocardial radiofrequency catheter ablation of VT in a large cohort of patients with ARVD/C. We studied from our ARVD/C registry (70 patients in total, 48 males, age 53.2 ± 14.0) 45 patients (64.3% of all patients) who underwent catheter ablation of VT. All patients received endocardial VT ablation. After endocardial ablation, 24 patients (53.3%) remained inducible. Additional epicardial ablation was performed in 22 patients (48.9%). After ablation, non-inducibility was achieved in overall 38 patients (84.4%). During a mean follow-up of 31.1 ± 27.4 months, 13 patients in each group (59.1% after endo- and epicardial ablation, 56.5% after endocardial ablation) remained free from VT recurrence (P = 0.862). An inducibility-guided catheter ablation strategy of VT in patients with ARVD/C prevents unnecessary epicardial ablation and may therefore be considered as an alternative to primary combined endo- and epicardial ablation.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Cardiomyopathy
Catheter ablation
Comorbidity
030204 cardiovascular system & hematology
Ventricular tachycardia
03 medical and health sciences
0302 clinical medicine
Heart Conduction System
Risk Factors
Germany
Physiology (medical)
Internal medicine
Prevalence
medicine
Humans
In patient
030212 general & internal medicine
Arrhythmogenic Right Ventricular Dysplasia
Retrospective Studies
business.industry
Patient Selection
Recurrent ventricular tachycardia
Middle Aged
medicine.disease
Ablation
Arrhythmogenic right ventricular dysplasia
Treatment Outcome
Radiofrequency catheter ablation
Catheter Ablation
Tachycardia, Ventricular
Cardiology
Cardiology and Cardiovascular Medicine
business
Pericardium
Subjects
Details
- ISSN :
- 15728595 and 1383875X
- Volume :
- 48
- Database :
- OpenAIRE
- Journal :
- Journal of Interventional Cardiac Electrophysiology
- Accession number :
- edsair.doi.dedup.....b73b6a92be4e338b332bd8cb3e8a3126