Arrhythmias & electrophysiologyCohort study
Catheter ablation of ventricular tachycardia in patients with arrhythmogenic right ventricular cardiomyopathy and biventricular involvement
- Retrospective cohort study
Authors' conclusion
Biventricular involvement implied a worse arrhythmic phenotype and increased the risk of left-sided VTs, while catheter ablation maintained its efficacy for VT control in this population. Younger age, lower RVEF, and non-acute complete success predicted VT recurrence after ablation.
Study context
- Population
- Definite arrhythmogenic right ventricular cardiomyopathy (ARVC) with sustained ventricular tachycardia (VTs) undergoing electrophysiological mapping and VT ablation
- Participants
- 98 participants
- Exposure
- ARVC with biventricular (BiV) involvement vs isolated right ventricular (RV) involvement, VT ablation
- BiVn = 50
- RVn = 48reference
- Outcome
- VT recurrence
Main finding
As reported in the abstract
Cumulative VT-free survival · 51 ± 34 months [median, 48 (22-83) months] of follow-up
P = 0.353
Observational data: associations, not effects.
Further findings
- Left-sided VTs (BiV)
- 20%
Clinical VT rate, VT inducibility, arrhythmogenic substrate extent
- BiV involvement associated with faster clinical VTs, higher VT inducibility and more extensive arrhythmogenic substrates
- all P < 0.05
Left-sided VTs (BiV)
- Correlated with significantly reduced LV systolic function
Acute ablation efficacy
- Acute ablation failure, left-sided VTs vs none: 40 vs. 5%
- P = 0.012
- Similar acute efficacy between the two groups
Predictors of VT recurrence (BiV, multivariate)
- Younger age, lower RV ejection fraction (RVEF) and non-acute complete ablation success associated with VT recurrence
Original publication
Catheter ablation of ventricular tachycardia in patients with arrhythmogenic right ventricular cardiomyopathy and biventricular involvement. Europace. Published 28 February 2024. doi:10.1093/europace/euae059
Summarised from the published abstract; every number is checked against it