Long-term follow-up of right ventricular monomorphic extrasystoles

Gaïta, Fiorenzo; Giustetto, Carla; Donna, Paolo Di; Richiardi, Elena; Libero, L; Brusin, Maria Cristina Rosa; Molinari, G.; Trevi, Giampaolo

doi:10.1016/s0735-1097(01)01403-6

Cited by 157 publications

(104 citation statements)

References 18 publications

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“…One issue would be the fact that the RVOT-PVC had been spontaneously suppressed. Gaita et al 19 conducted a longitudinal study in 61 patients with RVOT-PVC and observed that the symptoms disappeared spontaneously in two-thirds of patients for an average period of 15 years. However, one third of the patients persisted with RVOT-PVC and continued symptomatic.…”

Section: Discussionmentioning

confidence: 99%

Ablação com radiofreqüência de extra-sístoles da via de saída do ventrículo direito

Darrieux¹,

Scanavacca²,

Hachul³

et al. 2007

Arq. Bras. Cardiol.

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SummaryObjectives: To evaluate if radiofrequency catheter ablation is an effective procedure for the treatment of right ventricular outflow tract premature ventricular contraction (RVOT-PVC) and ascertain if it results in an improvement of symptoms.Methods: A prospective study with 30 consecutive patients (mean age 40 ± 13 years, 25 females), with no apparent structural cardiopathy, with very frequent (mean density of 1,263 ± 593/h) RVOT-PVC, symptomatic for more than one year (mean = 74 months) and resistant to antiarrhythmic drugs (3 ± 1.7, including beta-blockers), who underwent radiofrequency catheter ablation.Results: After the first procedure, there were 23 initial successful cases (76.6%) and 7 initial failures (23.4%). Four patients experienced relapses, two of whom did not undergo the second procedure. The second procedure was carried out in 9 patients (7 initial failures and 2 relapses), and there was success in 5 additional patients, one of them by epicardial access. The final success rate was 80% (24/30), and there were no major complications. After a mean follow-up of 14 ± 6 months, in the successful group there was a reduction greater than 90% in density of premature ventricular contractions (PVC) (24/24; p<0.0001) and a resulting absence of symptoms in the majority of patients (23/24; p<0.001).Conclusion: Radiofrequency catheter ablation is a safe and effective treatment for patients with persistent and symptomatic PVC with RVOT morphology.

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Section: Discussionmentioning

confidence: 99%

Ablação com radiofreqüência de extra-sístoles da via de saída do ventrículo direito

Darrieux¹,

Scanavacca²,

Hachul³

et al. 2007

Arq. Bras. Cardiol.

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“…Frequent premature ventricular complexes (PVCs) are one of the major causes of reversible cardiomyopathy [1][2][3]. Tachycardia induced cardiomyopathy belongs to the acquired dilative cardiomyopathies and requires exclusion of other underlying disorders and observation of left ventricle (LV) functional improvement after achievement of arrhythmia control for diagnosis [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“…Idiopathic PVCs in patients without structural heart disease (SHD) are usually considered benign [1][2][3]. Successful elimination of the PVCs, either by radiofrequency (RF), catheter ablation, or antiarrhythmic drugs, may improve or even normalise LV systolic function [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The effect of radiofrequency catheter ablation of frequent premature ventricular complexes and arrhythmia burden on left ventricular function

et al. 2017

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A b s t r a c tBackground: Frequent premature ventricular complexes (PVC) are related to reversible tachycardia-induced cardiomyopathy. However, the role of arrhythmia burden on the outcome of the catheter ablation has not been fully recognised. Aim:The aim of this study was to assess the effect of catheter ablation and PVC burden in patients with and without structural heart disease (SHD) on left ventricular ejection fraction (LVEF). Methods:Transthoracic echocardiography was done before and six months after radiofrequency catheter ablation in 109 consecutive patients (61 men, age 55 ± 17 years) with frequent PVCs. Sixty-five (59.6%) patients had underlying SHD. Results:The catheter ablation procedure was successful in 93 (85.3%) patients. Baseline PVC burden was higher in patients with SHD (22,267 ± 12,934) compared to those without concomitant SHD (15,546 ± 7888), p = 0.005. Nevertheless, patients with LVEF ≤ 50% at baseline presented greater LVEF recovery (from 44% to 56%) than those with LVEF > 50% at baseline after catheter ablation. In both groups, the LVEF improved (p < 0.001); however, no difference was observed between patients with SHD (5.7% ± 1.37%) and without (4.6% ± 0.96%) SHD; p = 0.89. PVC burden was higher in patients with (24,350 ± 2776 PVC/day) compared to those without (17,588 ± 1970 PVC/day) improvement of LVEF. In multivariate regression analysis PVC burden > 20,000/day (but not age, p = 0.95; gender, p = 0.89; presence of SHD, p = 0.53; QRS complex width of the treated PVC, p = 0.21, LVEF before ablation, p = 0.19; and site of origin, p = 47) predicted improvement in LVEF after successful catheter ablation (odds ratio: 3.53; 95% confidence interval: 1.15-10.75; p = 0.023). Conclusions:Catheter ablation of frequent PVCs improves left ventricular function in multivariate analysis predicted improvement of LVEF within six months after the successful catheter ablation procedure in patients with PVC burden exceeding 20,000/24 h.

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“…[16,17] In contrast, it has been reported that a small number of patients develop polymorphic VT and /or VF, thereby suggesting the malignant entity. [12,13,[18][19][20] There are several studies attempting to differentiate such a malignant form of RVOT-VT from a benign one.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve

et al. 2015

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AbstractsPanoptic studies of ventricular tachycardia (VT) originating above the pulmonary valve are scarce. The purpose of this study is to clarify the characteristic of idiopathic VT arising above pulmonary valve. We analyzed 15 consecutive patients with idiopathic VT that was successfully abolished by catheter ablation at the right ventricular outflow tract (RVOT-VT, n = 11) and above the pulmonary valve (PA-VT, n = 4). Incidence of syncope was higher in PA-VT than RVOT-VT (100 % vs 27 %, P < 0.05) and polymorphic VT was also more prevalent in PA-VT (75 % vs 0 %, P < 0.05). The coupling interval (315 ± 29 ms vs 449 ± 32 ms, mean ± SE) at the onset of VT and minimum cycle length (CL) (192 ± 13 ms vs 344 ± 37 ms) during VT were shorter in PA-VT (both P < 0.05). Among 12-lead ECG parameters, only R-wave amplitude in lead II was different between groups (2.05 ± 0.17 mV in PA-VT vs 1.44 ± 0.05 mV in RVOT-VT, P < 0.005). At the successful ablation site, the activation time from the onset of QRS complex did not differ between groups ( -37 ± 3 ms vs -31 ± 4 ms, P = 0.405), whereas the amplitude of intracardiac electrograms was significantly lower in PA-VT (0.83 ± 0.38 mV vs 2.39 ± 0.36 mV, P < 0.05). Although the number of patients in this study is limited, VT originating above the pulmonary valve demonstrated rapid excitation and often degenerated into polymorphic VT, suggesting its malignant electrophysiological characteristics.

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Long-term follow-up of right ventricular monomorphic extrasystoles

Abstract: In this long-term follow-up study, no patient died of sudden death nor developed ARVD; two-thirds of the patients were asymptomatic, and, in half of the patients, ectopy had disappeared. Focal fatty replacement in the right ventricle was present in most.

Cited by 157 publications

References 18 publications

Ablação com radiofreqüência de extra-sístoles da via de saída do ventrículo direito

Ablação com radiofreqüência de extra-sístoles da via de saída do ventrículo direito

The effect of radiofrequency catheter ablation of frequent premature ventricular complexes and arrhythmia burden on left ventricular function

Characteristics of idiopathic ventricular tachycardia originating above the pulmonary valve

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