Arrhythmias & electrophysiology
Catheter Ablation for Ventricular Tachycardia in Patients With Desmoplakin Cardiomyopathy
Authors' conclusion
VT ablation in DSP-ACM is effective in reducing the VA burden of the disease, but recurrences are common. Most VT circuits are epicardial, with both LV and RV low voltage abnormalities. Heart failure complicates clinical course and is an important cause of mortality.
Study context
- Population
- Patients with P/LP desmoplakin variants (DSP-ACM) undergoing ventricular tachycardia (VT) ablation
- Participants
- 24 patients
- Exposure
- Ventricular arrhythmia (VA) rates before vs after VT ablation
- Outcome
- Sustained VAs after the index procedure
Methodological detailsmulticentre (9 institutions), per-patient before and after ablation comparison
- Multicentre (9 institutions)
- Per-patient before and after ablation comparison
Main finding
As reported in the abstract
Sustained VA recurrence after index procedure · median 2.9 years (Q1-Q3: 1.8-5.5 years)
Patients with VA recurrences
13
54.2%
Observational data: associations, not effects.
Further findings
Per-patient VA events/year · significant reduction
P = 0.009
Substrate findings
- Endocardial/epicardial index procedure
- 19/24
- Low voltage potentials, right ventricle (RV) endocardium
- 10 of 15
- Low voltage potentials, left ventricle (LV) endocardium
- 11 of 16
- Endocardial ablation
- 18 (75.0%)
- Epicardial mapping; low voltage potentials found
- 19 (79.2%); 17
- Epicardial ablation
- 16
Heart transplantation and death
- Heart transplantation
- 2
- Death
- 4
- Death from HF
- 3
- Noncardiac death
- 1
Original publication
Catheter Ablation for Ventricular Tachycardia in Patients With Desmoplakin Cardiomyopathy. JACC Clin Electrophysiol. Published 10 January 2024. doi:10.
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