Purpose Frequent ventricular premature depolarizations (VPDs) may cause cardiomyopathy (VPDCM), which often improves after VPD suppression. This study aimed to evaluate whether ablation of outflow tract ventricular arrhythmias (OT VAs) in patients with VPDCM improves renal in addition to left ventricular (LV) function. Methods We retrospectively evaluated 153 patients with OT VAs and examined VPD burden and LV ejection fraction (LVEF), as well as estimated glomerular filtration rate (eGFR) pre- and post-ablation. LV dysfunction was defined as LVEF < 50 % and impaired renal function was defined as eGFR of < 60 mL/min/1.73m(2). Results Fifty-five patients had VPDCM. During mean follow-up of 14 months, 140 (92 %) were free from arrhythmia. In patients with VPDCM, patients with baseline LVEF 40-50 % had greater improvement in the post-ablation LVEF compared to patients with baseline LVEF < 40 % (p < 0.01). At baseline, 36 (72 %) patients had renal dysfunction, 29 (81 %) of whom had improvement in eGFR from baseline after successful ablation from eGFR 51 to 57 mL/min/1.73m(2). There was a significant association between cardiac (Delta LVEF >= 10 %) and renal (Delta eGFR >= 10 %) improvement (r = 0.54, p = 0.04). Using logistic regression analysis, procedural success was an independent predictor of improvement of cardiac (odds ratio [OR] = 13.7, p = 0.03) and renal function (OR = 21.0, p = 0.047). Conclusions Successful catheter ablation of OT VA reduces VPD burden and is associated with improved cardiac and renal function in patients with VPDCM.

Recovery of renal dysfunction after catheter ablation of outflow tract ventricular arrhythmias in patients with ventricular premature depolarization-mediated cardiomyopathy

Muser D;
2017-01-01

Abstract

Purpose Frequent ventricular premature depolarizations (VPDs) may cause cardiomyopathy (VPDCM), which often improves after VPD suppression. This study aimed to evaluate whether ablation of outflow tract ventricular arrhythmias (OT VAs) in patients with VPDCM improves renal in addition to left ventricular (LV) function. Methods We retrospectively evaluated 153 patients with OT VAs and examined VPD burden and LV ejection fraction (LVEF), as well as estimated glomerular filtration rate (eGFR) pre- and post-ablation. LV dysfunction was defined as LVEF < 50 % and impaired renal function was defined as eGFR of < 60 mL/min/1.73m(2). Results Fifty-five patients had VPDCM. During mean follow-up of 14 months, 140 (92 %) were free from arrhythmia. In patients with VPDCM, patients with baseline LVEF 40-50 % had greater improvement in the post-ablation LVEF compared to patients with baseline LVEF < 40 % (p < 0.01). At baseline, 36 (72 %) patients had renal dysfunction, 29 (81 %) of whom had improvement in eGFR from baseline after successful ablation from eGFR 51 to 57 mL/min/1.73m(2). There was a significant association between cardiac (Delta LVEF >= 10 %) and renal (Delta eGFR >= 10 %) improvement (r = 0.54, p = 0.04). Using logistic regression analysis, procedural success was an independent predictor of improvement of cardiac (odds ratio [OR] = 13.7, p = 0.03) and renal function (OR = 21.0, p = 0.047). Conclusions Successful catheter ablation of OT VA reduces VPD burden and is associated with improved cardiac and renal function in patients with VPDCM.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11699/83238
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