Changes in the isolated delayed component as an endpoint of catheter ablation in arrhythmogenic right ventricular cardiomyopathy: Predictor for long-term success
Changes in the isolated delayed component as an endpoint of catheter ablation in arrhythmogenic right ventricular cardiomyopathy: Predictor for long-term success
复制标题
DOI：
10.1111/j.1540-8167.2008.01104.x
复制
发表时间：
2008-07-01
影响因子：
2.7
通讯作者：
Naito, Shigeto
中科院分区：
文献类型：
--
作者：
Nogami, Akihiko;Sugiyasu, Aiko;Naito, Shigeto
简介：虽然室性心动过速（VT）的成功消融对于致心律失常性右室心肌病（ARVC）是可行的，但长期复发是常见的。本研究的目的是评估孤立延迟成分 (IDC) 变化作为 ARVC 导管消融终点的有用性。方法和结果：对 18 名 ARVC 患者（48 +/- 11 岁）进行了研究。在窦性心律期间对右心室 (RV) 进行详细的心内膜标测。 16例患者记录了IDC，最新的IDC与VT回路有关。在有 IDC 的区域进行导管消融。疗程结束时，1 例 IDC 电解离，5 例消失，1 例表现出二级阻滞，3 例显着延迟（>= 50 毫秒），6 例保持不变。 IDC 的变化与信号平均心电图 (ECG) 中 II/III 型晚电位的变化以及消融后临床 VT 的诱导能力相关。在 61 +/- 38 个月的随访期间，VT 在 6 个月内复发。 IDC发生改变的患者VT复发率显着低于无IDC或IDC未改变的患者（P < 0.02）。结论：在ARVC患者中，（1）窦性心律期间的IDC与临床VT相关，可以作为消融的目标；（2）IDC的改变可以作为终点；（3）连续信号平均心电图的定性分析可能有助于长期随访。
Introduction: Although successful ablation of ventricular tachycardia (VT) is feasible in arrhythmogenic right ventricular cardiomyopathy (ARVC), long-term recurrence is common. The aim of this study was to assess the usefulness of a change in the isolated delayed component (IDC) as an endpoint of the catheter ablation in ARVC.Methods and Results: Eighteen patients (48 +/- 11 years) with ARVC were studied. Detailed endocardial mapping of the right ventricle (RV) was performed during sinus rhythm. IDCs were recorded in 16 patients and the latest IDCs were related to the VT circuit. Catheter ablation was carried out in the areas with the IDCs. At the end of the session, the IDC was electrically dissociated in one, disappeared in five, exhibited second-degree block in one, was significantly delayed (>= 50 ms) in three, and remained unchanged in six. The change in the IDC was correlated with the change in the type II/III late potentials in the signal-averaged electrocardiography (ECG) and the inducibility of the clinical VT after the ablation. During a follow-up of 61 +/- 38 months, VT recurred in six. The patients with a changed IDC had a significantly lower VT recurrence than those with no IDC or an unchanged IDC (P < 0.02).Conclusion: In patients with ARVC, (1) the IDCs during sinus rhythm are related to the clinical VT and can be a target for the ablation, (2) a change in the IDC can be used as an endpoint, and (3) qualitative analyses of the serial signal-averaged ECGs may be useful for the long-term follow-up.