Incidence, Predictors, and Success of Ventricular Tachycardia Catheter Ablation in Arrhythmogenic Right Ventricular Cardiomyopathy (from the Nordic ARVC Registry)

Research output: Contribution to journalArticle

Abstract

Catheter ablation may reduce ventricular tachycardia (VT) burden in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. However, little is known about factors predicting need for ablation. Therefore, we sought to investigate predictors and use of VT ablation and to evaluate the postprocedural outcome in ARVC patients. We studied 435 patients from the Nordic ARVC registry including 220 probands with definite ARVC according to the 2010 task force criteria and 215 mutation-carrying relatives identified through cascade screening. Patients were followed until first-time VT ablation, death, heart transplantation, or January 1st 2018. Additionally, patients undergoing VT ablation were further followed from the time of ablation for recurrent ventricular arrhythmias. The cumulative use of VT ablation was 4% (95% confidence interval [CI] 3% to 6%) and 11% (95% CI 8% to 15%) after 1 and 10 years. All procedures were performed in probands in whom cumulative use was 8% (95% CI 5% to 12%) and 20% (95% CI 15% to 26%). In adjusted analyses among probands, only young age predicted ablation. In patients undergoing ablation, risk of recurrent arrhythmias was 59% (95% CI 44% to 71%) and 74% (95% CI 59% to 84%) 1 and 5 years after the procedure. Despite high recurrence rates, the burden of ventricular arrhythmias was reduced after ablation (p = 0.0042). Young age, use of several antiarrhythmic drugs and inducibility to VT after ablation were associated with an unfavorable outcome. In conclusion, twenty percent of ARVC probands developed a clinical indication for VT ablation within 10 years whereas mutation-carrying relatives were without such need. Although the burden of ventricular arrhythmias decreased after ablation, risk of recurrence was substantial.

Details

Authors
  • Morten K. Christiansen
  • Kristina H. Haugaa
  • Anneli Svensson
  • Thomas Gilljam
  • Trine Madsen
  • Jim Hansen
  • Anders G. Holst
  • Henning Bundgaard
  • Thor Edvardsen
  • Jesper H. Svendsen
  • Pyotr G. Platonov
  • Henrik K. Jensen
Organisations
External organisations
  • Aarhus University Hospital
  • Aarhus University
  • Oslo university hospital
  • Linköping University
  • Sahlgrenska University Hospital
  • Aalborg University Hospital
  • University of Copenhagen
  • Copenhagen University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems
Original languageEnglish
Pages (from-to)803-811
Number of pages9
JournalAmerican Journal of Cardiology
Volume125
Issue number5
Early online date2019 Dec 9
Publication statusE-pub ahead of print - 2019 Dec 9
Publication categoryResearch
Peer-reviewedYes