Ying-Chieh Liao1, Fa-Po Chung2, Yenn-Jiang Lin2, Shih-Lin Chang2, Li-Wei Lo2, Yu-Feng Hu2, Ta-Chuan Tuan2, Tze-Fan Chao2, Jo-Nan Liao2, Chin-Yu Lin2, Yao-Ting Chang2, Ming-Hsiung Hsieh3, Shih-Ann Chen2. 1. Division of Electrophysiology, Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan. 2. Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan. 3. Division of Cardiology, Department of Internal Medicine, Taipei Wan-Fang Hospital, Taipei Medical University, Taiwan; Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taiwan. Electronic address: mhhsieh@tmu.edu.tw.
Abstract
BACKGROUND: The changes of signal averaged ECG (SAECG) in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) undergoing radiofrequency catheter ablation (RFCA) of ventricular arrhythmias (VAs) remains unknown. METHODS: Between 2010 and 2014, a total of 81 ARVD/C patients underwent endocardial and/or epicardial RFCA for drug-refractory VAs. Seventy patients (mean age 46.2±14.1years, 37 males) achieving acute procedure success (negative inducibility) were enrolled. Baseline characteristics, non-invasive examinations and SAECG (before and 3months after RFCA) were collected retrospectively. RESULTS: After successful RFCA, the electrical parameters of SAECG changed in 39 patients (55.7%), including 28 patients (40%) with electrical regression (group 1), and 11 patients (15.7%) with electrical progression (group 3). Thirty-one patients (44.3%) showed no significant SAECG change (group 2). During a mean follow-up of 17.8±10.7months, 23 patients (32.9%) had VA recurrences, including 4 in group 1, 12 in group 2, and 7 in group 3. In comparisons with groups 2 and 3, group 1 patients had a significantly better VA recurrence-free survival (P=0.02). In multivariable Cox regression analysis, electrical regression was found to be associated with fewer VA recurrences (P=0.02, OR: 0.28, 95% CI: 0.10-0.83). CONCLUSIONS: Electrical regression of SAECG after RFCA in ARVD/C was found to be associated with fewer VA recurrences.
BACKGROUND: The changes of signal averaged ECG (SAECG) in patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) undergoing radiofrequency catheter ablation (RFCA) of ventricular arrhythmias (VAs) remains unknown. METHODS: Between 2010 and 2014, a total of 81 ARVD/C patients underwent endocardial and/or epicardial RFCA for drug-refractory VAs. Seventy patients (mean age 46.2±14.1years, 37 males) achieving acute procedure success (negative inducibility) were enrolled. Baseline characteristics, non-invasive examinations and SAECG (before and 3months after RFCA) were collected retrospectively. RESULTS: After successful RFCA, the electrical parameters of SAECG changed in 39 patients (55.7%), including 28 patients (40%) with electrical regression (group 1), and 11 patients (15.7%) with electrical progression (group 3). Thirty-one patients (44.3%) showed no significant SAECG change (group 2). During a mean follow-up of 17.8±10.7months, 23 patients (32.9%) had VA recurrences, including 4 in group 1, 12 in group 2, and 7 in group 3. In comparisons with groups 2 and 3, group 1 patients had a significantly better VA recurrence-free survival (P=0.02). In multivariable Cox regression analysis, electrical regression was found to be associated with fewer VA recurrences (P=0.02, OR: 0.28, 95% CI: 0.10-0.83). CONCLUSIONS: Electrical regression of SAECG after RFCA in ARVD/C was found to be associated with fewer VA recurrences.
Authors: Ka Hou Christien Li; George Bazoukis; Tong Liu; Guangping Li; William K K Wu; Sunny Hei Wong; Wing Tak Wong; Yat Sun Chan; Martin C S Wong; Katharina Wassilew; Vassilios S Vassiliou; Gary Tse Journal: J Arrhythm Date: 2017-12-21