Derek Lee1,2, Kurt S Hoffmayer1,2, Jonathan C Hsu1,2, Amir Schricker1,2, Ulrika Birgersdotter-Green1,2, Farshad Raissi1,2, Gregory K Feld1,2, David E Krummen3,4. 1. Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, CA, USA. 2. VA San Diego Healthcare System, 3350 La Jolla Village Drive, Cardiology Section 111A, San Diego, CA, 92161, USA. 3. Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, CA, USA. dkrummen@ucsd.edu. 4. VA San Diego Healthcare System, 3350 La Jolla Village Drive, Cardiology Section 111A, San Diego, CA, 92161, USA. dkrummen@ucsd.edu.
Abstract
PURPOSE: Catheter ablation of premature ventricular contractions (PVCs) is highly successful and has become the hallmark treatment for symptomatic or highly prevalent cases. However, few studies exist that evaluate the outcomes of ablation and likely mechanisms of PVC recurrence beyond 1 year of follow-up. METHODS: This study is a retrospective analysis of patients who underwent catheter ablation for symptomatic PVCs with acute procedural success and had clinical follow-up ≥ 12 months. RESULTS: Forty-four patients (24 women; age 53.5 ± 4.8 years) following acutely successful PVC ablation with long-term follow-up were studied. At a mean of 36 ± 6 months, overall long-term ablation success was 75% (33/44 patients). Notably, recurrence of the targeted PVC focus was low (6.8%, 3/44 patients); the majority of recurrences were from a new source location (18.2%, 8/44 patients). The time course for targeted versus de novo PVC recurrences was significantly different: recurrence of a PVC similar to the targeted PVC morphology occurred at a mean of 5.0 ± 2.0 months, while recurrence of a PVC different from the index case occurred at a mean of 35.8 ± 17.1 months (p = 0.01). Non-ischemic cardiomyopathy was associated with increased risk of PVC recurrence (odds ratio [OR] 14.50 (95% confidence interval [CI] 1.92-109.33, p = 0.01)) and was a significant negative prognostic factor in multivariate analysis for PVC recurrence survival (hazard ratio [HR] 4.63, 95% CI 1.03-20.74, p = 0.04). CONCLUSIONS: The majority of long-term PVC recurrences occur late in follow-up, at locations remote from the targeted PVC source or sources. Such sites may represent ongoing substrate evolution; additional work is required to determine the precise substrate alterations which promote such arrhythmogenic changes.
PURPOSE: Catheter ablation of premature ventricular contractions (PVCs) is highly successful and has become the hallmark treatment for symptomatic or highly prevalent cases. However, few studies exist that evaluate the outcomes of ablation and likely mechanisms of PVC recurrence beyond 1 year of follow-up. METHODS: This study is a retrospective analysis of patients who underwent catheter ablation for symptomatic PVCs with acute procedural success and had clinical follow-up ≥ 12 months. RESULTS: Forty-four patients (24 women; age 53.5 ± 4.8 years) following acutely successful PVC ablation with long-term follow-up were studied. At a mean of 36 ± 6 months, overall long-term ablation success was 75% (33/44 patients). Notably, recurrence of the targeted PVC focus was low (6.8%, 3/44 patients); the majority of recurrences were from a new source location (18.2%, 8/44 patients). The time course for targeted versus de novo PVC recurrences was significantly different: recurrence of a PVC similar to the targeted PVC morphology occurred at a mean of 5.0 ± 2.0 months, while recurrence of a PVC different from the index case occurred at a mean of 35.8 ± 17.1 months (p = 0.01). Non-ischemic cardiomyopathy was associated with increased risk of PVC recurrence (odds ratio [OR] 14.50 (95% confidence interval [CI] 1.92-109.33, p = 0.01)) and was a significant negative prognostic factor in multivariate analysis for PVC recurrence survival (hazard ratio [HR] 4.63, 95% CI 1.03-20.74, p = 0.04). CONCLUSIONS: The majority of long-term PVC recurrences occur late in follow-up, at locations remote from the targeted PVC source or sources. Such sites may represent ongoing substrate evolution; additional work is required to determine the precise substrate alterations which promote such arrhythmogenic changes.
Authors: Ravi K Yarlagadda; Sei Iwai; Kenneth M Stein; Steven M Markowitz; Bindi K Shah; Jim W Cheung; Vivian Tan; Bruce B Lerman; Suneet Mittal Journal: Circulation Date: 2005-08-15 Impact factor: 29.690
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Authors: Bernas Altıntaş; Flora Özkalaycı; Göksel Çinier; İlyas Kaya; Adem Aktan; Ayhan Küp; Raşit Onuk; Sevgi Özcan; Abdulkadir Uslu; Abdurrahman Akyüz; Adem Atıcı; Selim Ekinci; Halil Akın; Mehmet Fatih Yılmaz; Şahbender Koç; Veysel Ozan Tanık; Hazar Harbalıoğlu; Hasan Ali Barman; Abdülmecit Afşin; Ayça Gümüşdağ; Hayrudin Alibaşiç; Yavuz Karabağ; Murat Cap; Erkan Baysal; İbrahim Halil Tanboğa Journal: Ann Noninvasive Electrocardiol Date: 2019-09-22 Impact factor: 1.468