Ablation of ventricular arrhythmias in arrhythmogenic right ventricular dysplasia/cardiomyopathy: Arrhythmia-free survival after endo-epicardial substrate based mapping and ablationablation of ventricular arrhythmias in arrhythmogenic right ventricular dysplasia/cardiomyopathy arrhythmia-free survival after endo-epicardial substrate based mapping and ablation

Rong Bai, Luigi Di Biase, Kalyanam Shivkumar, Prasant Mohanty, Roderick Tung, Pasquale Santangeli, Luis Saenz Carlos, Miguel Vacca, Atul Verma, Yariv Khaykin, Sanghamitra Mohanty, J. David Burkhardt, Richard Hongo, Salwa Beheiry, Antonio Dello Russo, Michela Casella, Gemma Pelargonio, Pietro Santarelli, Javier Sanchez, Claudio TondoAndrea Natale

Research output: Contribution to journalArticle

Abstract

Background-In patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy, freedom from ventricular arrhythmias (VAs) after endocardial ablation is limited. We compared the long-term freedom from recurrent VAs by using endocardial-alone ablation versus endo-epicardial substrate-based ablation. Methods and Results-Forty-nine patients with arrhythmogenic right ventricular dysplasia/cardiomyopathy undergoing ablation of ventricular tachycardia (VT) were divided into 2 groups: endocardial-alone ablation (group 1, n=23) and endo-epicardial ablation (group 2, n=26). All patients had an implantable cardioverter-defibrillator (ICD). Conventional and 3D mappings were used to determine the mechanism of induced VTs and to identify area of "scar" or "abnormal" myocardium. All critical sites responsible for VTs and points with "abnormal" potential were targeted for ablation from endocardium (group 1) or from both endocardium and epicardium (group 2). The procedural end point was noninducibility of sustained, monomorphic VT with isoproterenol. The presence of frequent premature ventricular contractions at the end of ablation was recorded. Patients were followed up by ECG, Holter, and ICD interrogation. After a follow-up of at least 3 years, freedom from VAs or ICD therapy was 52.2% (12/23) in group 1 and 84.6% (22/26) in group 2 (P=0.029), with 21.7% (5/23) and 69.2% (18/26) patients off antiarrhythmic drugs (P

Original languageEnglish
Pages (from-to)478-485
Number of pages8
JournalCirculation: Arrhythmia and Electrophysiology
Volume4
Issue number4
DOIs
Publication statusPublished - Aug 2011

    Fingerprint

Keywords

  • Ablation
  • Arrhythmogenic right ventricular dysplasia
  • Cardiomyopathy
  • Epicardial
  • Premature ventricular contraction
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this