Outcomes of Catheter Ablation of Ventricular Tachycardia Based on Etiology in Nonischemic Heart Disease An International Ventricular Tachycardia Ablation Center Collaborative Study
Outcomes of Catheter Ablation of Ventricular Tachycardia Based on Etiology in Nonischemic Heart Disease An International Ventricular Tachycardia Ablation Center Collaborative Study
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DOI：
10.1016/j.jacep.2018.05.007
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发表时间：
2018-09-01
影响因子：
7
通讯作者：
Shivkumar, Kalyanam
中科院分区：
文献类型：
--
作者：
Vaseghi, Marmar;Hu, Tiffany Y.;Shivkumar, Kalyanam
结论本研究旨在描述非缺血性心肌病（NICM）病因中室性心动过速（VT）消融结果的特征，并通过可解释心律失常复发率差异的患者相关合并症调整这些结果。回顾性分析了来自12个国际中心的075例结构性心脏病患者的VT导管消融术。记录了6种最常见NICM病因的患者特征和结局。多变量考克斯比例风险模型用于调整潜在的混杂因素。（57 +/- 14岁，18%为女性，左心室射血分数37 +/- 13%），原发性扩张型心肌病（DICM）的基础患病率为66%，致瘤性右心室心肌病（ARVC）为13%，瓣膜性心肌病为6%，6%为心肌炎，4%为肥厚型心肌病，3%为结节病。一年内无室性心动过速发生率为69%，无室性心动过速、心脏移植和死亡发生率为62%。在未校正的竞争风险分析中，ARVC的VT消融术显示了上级无VT生存率（82%）优于DICM（p
OBJECTIVES This study sought to characterize ventricular tachycardia (VT) ablation outcomes across nonischemic cardiomyopathy (NICM) etiologies and adjust these outcomes by patient-related comorbidities that could explain differences in arrhythmia recurrence rates.BACKGROUND Outcomes of catheter ablation of VT in patients with NICM could be related to etiology of NICM.METHODS Data from 2,075 patients with structural heart disease referred for catheter ablation of VT from 12 international centers was retrospectively analyzed. Patient characteristics and outcomes were noted for the 6 most common NICM etiologies. Multivariable Cox proportional hazards modeling was used to adjust for potential confounders.RESULTS Of 780 NICM patients (57 +/- 14 years of age, 18% women, left ventricular ejection fraction 37 +/- 13%), underlying prevalence was 66% for dilated idiopathic cardiomyopathy (DICM), 13% for arrhythmogenic right ventricular cardiomyopathy (ARVC), 6% for valvular cardiomyopathy, 6% for myocarditis, 4% for hypertrophic cardiomyopathy, and 3% for sarcoidosis. One-year freedom from VT was 69%, and freedom from VT, heart transplantation, and death was 62%. On unadjusted competing risk analysis, VT ablation in ARVC demonstrated superior VT-free survival (82%) versus DICM (p