دورية أكاديمية
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Catheter Ablation for Ventricular Tachycardia in Patients With Desmoplakin Cardiomyopathy.

التفاصيل البيبلوغرافية
العنوان: Catheter Ablation for Ventricular Tachycardia in Patients With Desmoplakin Cardiomyopathy.
المؤلفون: Gasperetti A; Department of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy; Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino, IRCCS, Milan, Italy., Peretto G; Department of Cardiac Electrophysiology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Muller SA; Department of Cardiology, Division Heart and Lungs, Utrecht University Medical Centre, Utrecht, the Netherlands., Hasegawa K; Department of Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Compagnucci P; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy; Cardiology and Arrhythmology Clinic, University Hospital 'Azienda Ospedaliero-Universitaria delle Marche,' Ancona, Italy., Casella M; Cardiology and Arrhythmology Clinic, University Hospital 'Azienda Ospedaliero-Universitaria delle Marche,' Ancona, Italy; Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona, Italy., Murray B; Department of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA., Tichnell C; Department of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA., Carrick RT; Department of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA., Cadrin-Tourigny J; Cardiovascular Genetics Center and Electrophysiology Service, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada., Schiavone M; Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Cardiology, Luigi Sacco University Hospital, Milan, Italy., James C; Department of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA., Amin AS; Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam, the Netherlands., Saguner AM; Department of Cardiology, University Hospital of Zurich, Zurich, Switzerland; Center for Translational and Experimental Cardiology, Department of Cardiology, Zurich University Hospital, University of Zurich, Schlieren, Switzerland., Dello Russo A; Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Ancona, Italy; Cardiology and Arrhythmology Clinic, University Hospital 'Azienda Ospedaliero-Universitaria delle Marche,' Ancona, Italy., Tondo C; Department of Clinical Electrophysiology and Cardiac Pacing, Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy., Stevenson W; Department of Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA., Della Bella P; Department of Cardiac Electrophysiology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Calkins H; Department of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA., Tandri H; Department of Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA. Electronic address: hari.tandri@vumc.org.
المصدر: JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2024 Mar; Vol. 10 (3), pp. 487-498. Date of Electronic Publication: 2024 Jan 10.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101656995 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2405-5018 (Electronic) Linking ISSN: 2405500X NLM ISO Abbreviation: JACC Clin Electrophysiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [New York, NY] : Elsevier Inc., [2015]-
مواضيع طبية MeSH: Arrhythmogenic Right Ventricular Dysplasia*/complications , Arrhythmogenic Right Ventricular Dysplasia*/surgery , Tachycardia, Ventricular* , Cardiomyopathies*/etiology , Catheter Ablation*/methods , Heart Failure*/etiology, Humans ; Male ; Middle Aged ; Female ; Desmoplakins ; Treatment Outcome
مستخلص: Background: Desmoplakin (DSP) pathogenic/likely pathogenic (P/LP) variants are associated with malignant phenotypes of arrhythmogenic cardiomyopathy (DSP-ACM). Reports of outcomes after ventricular tachycardia (VT) ablation in DSP-ACM are scarce.
Objectives: In this study, the authors sought to report on long-term outcomes of VT ablation in DSP-ACM.
Methods: Patients with P/LP DSP variants at 9 institutions undergoing VT ablation were included. Demographic, clinical, and instrumental data as well as all ventricular arrhythmia (VA) events were collected. Sustained VAs after the index procedure were the primary outcome. A per-patient before and after ablation comparison of rates of VA episodes per year was performed as well.
Results: Twenty-four DSP-ACM patients (39.3 ± 12.1 years of age, 62.5% male, median 6,116 [Q1-Q3: 3,362-7,760] premature ventricular complexes [PVCs] per 24 hours, median 4 [Q1-Q3: 2-11] previous VA episodes per patient at ablation) were included. Index procedure was most commonly endocardial/epicardial (19/24) The endocardium of the right ventricle (RV), the left ventricle (LV), or both ventricles were mapped in 8 (33.3%), 9 (37.5%), and 7 (29.2%) cases, respectively. Low voltage potentials were found in 10 of 15 patients in the RV and 11 of 16 in the LV. Endocardial ablation was performed in 18 patients (75.0%). Epicardial mapping in 19 patients (79.2%) identified low voltage potentials in 17, and 16 received epicardial ablation. Over the following 2.9 years (Q1-Q3: 1.8-5.5 years), 13 patients (54.2%) experienced VA recurrences. A significant reduction in per-patient event/year before and after ablation was observed (1.4 [Q1-Q3: 0.5-2.4] to 0.1 [Q1-Q3: 0.0-0.4]; P = 0.009). Two patients needed heart transplantation, and 4 died (3 of heart failure and 1 noncardiac death).
Conclusions: VT ablation in DSP-ACM is effective in reducing the VA burden of the disease, but recurrences are common. Most VT circuits are epicardial, with both LV and RV low voltage abnormalities. Heart failure complicates clinical course and is an important cause of mortality.
Competing Interests: Funding Support and Author Disclosures The Johns Hopkins ARVC program is supported by the Leonie-Wild Foundation, the Leyla Erkan Family Fund for ARVD Research, the Hugh Calkins, Marvin H. Weiner, and Jacqueline J. Bernstein Cardiac Arrhythmia Center, the Dr Francis P. Chiramonte Private Foundation, the Dr Satish, Rupal, and Robin Shah ARVD Fund at Johns Hopkins, the Bogle Foundation, the Campanella family, the Patrick J. Harrison Family, the Peter French Memorial Foundation, and the Wilmerding Endowments and National Institutes of Health/National Center for Advancing Translational Sciences (UL1 TR003098). The Zurich ARVC Program is supported by the Georg und Bertha Schwyzer-Winiker Foundation, the Baugarten Foundation, the Wild Foundation, the Swiss National Science Foundation, and the Swiss Heart Foundation. Dr Cadrin-Tourigny is a clinical research scholar from the Fond de Recherche du Québec-Santé and receives support from the Philippa and Marvin Carsley Cardiology Research Chair and the Montreal Heart Institute Foundation. Dr Stevenson has received honoraria from Abbott, Boston Scientific, Medtronic, Biotronik, and Johnson and Johnson. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: SCD; VT ablation; arrhythmogenic cardiomyopathy; desmoplakin; epicardial procedure
المشرفين على المادة: 0 (Desmoplakins)
تواريخ الأحداث: Date Created: 20240111 Date Completed: 20240329 Latest Revision: 20240329
رمز التحديث: 20240329
DOI: 10.1016/j.jacep.2023.11.017
PMID: 38206263
قاعدة البيانات: MEDLINE
الوصف
تدمد:2405-5018
DOI:10.1016/j.jacep.2023.11.017