Outcome of catheter ablation of non-reentrant ventricular arrhythmias in patients with and without structural heart disease

Abstract

Background: Catheter ablation of non-reentrant, commonly termed "idiopathic" ventricular arrhythmias (VA) is highly effective in patients without structural heart disease (SHD). Meanwhile, the outcome of catheter ablation of these arrhythmias in patients with SHD remains unclear. This study sought to characterize the outcome of patients with and without SHD undergoing catheter ablation of non-reentrant VA. Methods: In this single-centre study the acute and long-term outcome of 266 consecutive patients undergoing catheter ablation of non-reentrant VA was investigated. In 41.0% of patients a SHD was present (n = 109, 80.7% male, age 59.1 ± 14.7 years), 59.0% had no SHD (n = 157; 44.0% male, age 49.9 ± 16.5 years). Results: Acute procedural success (absence of spontaneous or provoked VA at the end of procedure and within 48 h after the procedure) was achieved in 89.9% of patients with SHD vs. 94.3% without SHD (p = 0.238). During a mean follow-up of 34.7 ± 15.1 months a repeat catheter ablation was performed in 19.6% of patients with SHD vs. 13.0% without SHD (p = 0.179). Patients with dilated cardiomyopathy (DCM) were the most likely to require a repeat ablation procedure (32.0% of patients with DCM vs. 13.0% without SHD; p = 0.022). Periprocedural complications occurred in 5.5% of patients with SHD vs. 5.7% without SHD (p > 0.999). All complications were managed without sequelae. Conclusions: The outcome of catheter ablation of non-reentrant VA in patients with SHD appears good and is comparable to patients without SHD. A slightly higher rate of repeat ablations was observed in patients with DCM.

Ablation of Outflow Tract Arrhythmias in Patients With and Without Structural Heart Disease—A Comparative Analysis

“…Two previous publications investigated the origin and outcome of ventricular arrhythmias unrelated to myocardial substrate in patients with SHD, showing, that “idiopathic arrhythmias” remote from abnormal myocardial substrate do occur in those patients and have an acceptable ablation outcome ( 17 , 18 ). Arrhythmias associated with abnormal myocardial substrate on the other hand tend to have a worse ablation outcome, but several other confounding factors such as the accessibility of area of origin of the arrhythmia might be important ( 4 ).…”

Sudden cardiac death: epidemiology, pathogenesis and management

“…The procedure is more effective in patients without structural heart abnormalities than patients with structural heart abnormalities. However, 22% of patients without structural heart abnormality and 15% of the patients with structural heart abnormality will require repeated ablation [80]. Common procedural complications are correlated to access sites, such as groin hematoma and pseudoaneuysm [80].…”

Endo-epicardial mapping and radiofrequency catheter ablation of the ventricular arrhythmia of the left ventricle anterobasal zone (summit)

“…JOURNAL OF ARRHYTHMOLOGY, № 2 (100), 2020 турного поражения сердца [3,4]. Хотя многие из них могут быть эффективно вылечены радиочастотной катетерной аблацией, ЖЭ, исходящие из антеросептальной зоны (саммит ЛЖ), наиболее передней части ЛЖ, остаются сложной проблемой для РЧА.…”