Reversal of outflow tract ventricular premature depolarization-induced cardiomyopathy with ablation: Effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome
Reversal of outflow tract ventricular premature depolarization-induced cardiomyopathy with ablation: Effect of residual arrhythmia burden and preexisting cardiomyopathy on outcome
复制标题
DOI：
10.1016/j.hrthm.2011.04.026
复制
发表时间：
2011-10-01
期刊：
影响因子：
5.5
通讯作者：
Marchlinski, Francis E.
中科院分区：
文献类型：
--
作者：
Mountantonakis, Stavros E.;Frankel, David S.;Marchlinski, Francis E.
背景流出道室性早搏(VPD)可与可逆性左心室心肌病(LVCM)相关。关于VPD诊断前左室流出道VPD消融后的结果，以及VPD诊断前残留VPD或原有的LVCM对左心功能恢复的影响的数据有限。目的研究射频消融对LVCM和频繁流出道VPD患者左心功能的安全性、有效性和长期影响，并检查在VPD发生之前已知的LVCM患者消融的效果以及残余VPD频率对左心功能恢复的影响。非缺血型LVCM(左心室射血分数(LVEF)35%+/-9%，左心室舒张期内径(LVDD)5.8+/-0.7 cm)消融频发流出道室间隔缺损(29%+/-13%)。随访11+/-6个月，44例(66%)VPD负荷极少减轻(减少80%，通常为80%)，其左心功能改善程度与完全消除VPD相当。成功的VPD消融可能是有益的，即使是在既往有左室心肌的患者。
BACKGROUND Outflow tract ventricular premature depolarizations (VPDs) can be associated with reversible left ventricular cardiomyopathy (LVCM). Limited data exist regarding the outcome after ablation of outflow tract VPDs from the LV and the impact of residual VPDs or preexisting LVCM prior to the diagnosis of VPDs on recovery of LV function.OBJECTIVE To examine the safety, efficacy, and long-term effect of radiofrequency ablation on LV function in patients with LVCM and frequent outflow tract VPDs and examine the effect of ablation in patients with LVCM known to precede the onset of VPDs and the impact of residual VPD frequency on recovery of LV function.METHODS Sixty-nine patients (43 men; age 51 +/- 16 years) with nonischemic LVCM (left ventricular ejection fraction [LVEF] 35% +/- 9%, left ventricular diastolic diameter [LVDD] 5.8 +/- 0.7 cm) were referred for ablation of frequent outflow tract VPDs (29% +/- 13%).RESULTS VPDs originated in the right ventricular outflow tract in 27 (39%) patients and the left ventricular outflow tract in 42 (61%) patients. After follow-up of 11 +/- 6 months, 44 (66%) patients had rare (80% reduction and always 80%) reduction in VPD burden has comparable improvement in LV function to complete VPD elimination. Successful VPD ablation may be beneficial even in patients with preexisting LVCM.