Efficacy of catheter ablation for atrial arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy—a multicenter study
(2021) In Journal of Clinical Medicine 10(21).- Abstract
Background: Atrial arrhythmias are present in up to 20% of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Catheter ablation (CA) is an effective treatment for atrial arrhythmias in the general population. Data regarding CA for atrial arrhythmias in ARVC are scarce. Objective: To assess the safety and efficacy of CA for atrial arrhythmias in patients with ARVC. Methods: In this international collaborative effort, all patients with a definite diagnosis of ARVC undergoing CA for atrial fibrillation (AF), focal atrial tachycardia (AT), or cavotricuspid isthmus (CTI)‐dependent atrial flutter (AFl) were extracted from twelve ARVC registries. Demographic, periprocedural, and long‐term arrhythmic outcome data were... (More)
Background: Atrial arrhythmias are present in up to 20% of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Catheter ablation (CA) is an effective treatment for atrial arrhythmias in the general population. Data regarding CA for atrial arrhythmias in ARVC are scarce. Objective: To assess the safety and efficacy of CA for atrial arrhythmias in patients with ARVC. Methods: In this international collaborative effort, all patients with a definite diagnosis of ARVC undergoing CA for atrial fibrillation (AF), focal atrial tachycardia (AT), or cavotricuspid isthmus (CTI)‐dependent atrial flutter (AFl) were extracted from twelve ARVC registries. Demographic, periprocedural, and long‐term arrhythmic outcome data were collected. Results: Thirty‐seven patients were enrolled in the study (age 50.2 ± 16.6 years, male 84%, CHA2DS2VASc 1 (1,2), HAS‐BLED 0 (0–2)). The arrhythmia leading to CA was AF in 23 (62%), focal left AT in 5 (14%), and CTI‐dependent AFl in 9 (24%). Acute procedural success was achieved in all procedures but one (n = 1 focal left AT; 97% acute success). The median follow‐up period was 27 (13–67) months, and 96%, 74%, and 61% of patients undergoing AF ablation were free from any atrial arrhythmia recurrence after a single procedure at 6 months, 12 months, and last follow‐up, respectively. After focal AT ablation, freedom from atrial arrhythmia recurrence was 80%, 80%, and 60% at 6 months, 12 months, and last follow‐up, respectively. All patients undergoing CTI ablation were free from atrial arrhythmia recurrences at 6 months, with 89% single‐procedural arrhythmic freedom at last follow‐up. One major complication (2.7%; PV stenosis requiring PV stenting) occurred. Conclusions: CA is safe and effective in managing atrial arrhythmias in patients with ARVC, with success rates comparable to the general population.
(Less)
- author
- publishing date
- 2021-11-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Ablation in special populations, Arrhythmogenic right ventricular cardiomyopathy, Atrial fibrillation, Atrial flutter, Pulmonary vein isolation
- in
- Journal of Clinical Medicine
- volume
- 10
- issue
- 21
- article number
- 4962
- publisher
- MDPI AG
- external identifiers
-
- scopus:85117907080
- pmid:34768482
- ISSN
- 2077-0383
- DOI
- 10.3390/jcm10214962
- language
- English
- LU publication?
- no
- additional info
- Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
- id
- 7733eb5c-6c6b-4034-b615-5743f0678839
- date added to LUP
- 2021-11-22 14:08:31
- date last changed
- 2024-06-15 21:12:02
@article{7733eb5c-6c6b-4034-b615-5743f0678839,
abstract = {{<p>Background: Atrial arrhythmias are present in up to 20% of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Catheter ablation (CA) is an effective treatment for atrial arrhythmias in the general population. Data regarding CA for atrial arrhythmias in ARVC are scarce. Objective: To assess the safety and efficacy of CA for atrial arrhythmias in patients with ARVC. Methods: In this international collaborative effort, all patients with a definite diagnosis of ARVC undergoing CA for atrial fibrillation (AF), focal atrial tachycardia (AT), or cavotricuspid isthmus (CTI)‐dependent atrial flutter (AFl) were extracted from twelve ARVC registries. Demographic, periprocedural, and long‐term arrhythmic outcome data were collected. Results: Thirty‐seven patients were enrolled in the study (age 50.2 ± 16.6 years, male 84%, CHA2DS2VASc 1 (1,2), HAS‐BLED 0 (0–2)). The arrhythmia leading to CA was AF in 23 (62%), focal left AT in 5 (14%), and CTI‐dependent AFl in 9 (24%). Acute procedural success was achieved in all procedures but one (n = 1 focal left AT; 97% acute success). The median follow‐up period was 27 (13–67) months, and 96%, 74%, and 61% of patients undergoing AF ablation were free from any atrial arrhythmia recurrence after a single procedure at 6 months, 12 months, and last follow‐up, respectively. After focal AT ablation, freedom from atrial arrhythmia recurrence was 80%, 80%, and 60% at 6 months, 12 months, and last follow‐up, respectively. All patients undergoing CTI ablation were free from atrial arrhythmia recurrences at 6 months, with 89% single‐procedural arrhythmic freedom at last follow‐up. One major complication (2.7%; PV stenosis requiring PV stenting) occurred. Conclusions: CA is safe and effective in managing atrial arrhythmias in patients with ARVC, with success rates comparable to the general population.</p>}},
author = {{Gasperetti, Alessio and James, Cynthia A. and Chen, Liang and Schenker, Niklas and Casella, Michela and Kany, Shinwan and Mathew, Shibu and Compagnucci, Paolo and Müssigbrodt, Andreas and Jensen, Henrik K. and Svensson, Anneli and Costa, Sarah and Forleo, Giovanni B. and Platonov, Pyotr G. and Tondo, Claudio and Song, Jiang Ping and Russo, Antonio Dello and Ruschitzka, Frank and Brunckhorst, Corinna and Calkins, Hugh and Duru, Firat and Saguner, Ardan M.}},
issn = {{2077-0383}},
keywords = {{Ablation in special populations; Arrhythmogenic right ventricular cardiomyopathy; Atrial fibrillation; Atrial flutter; Pulmonary vein isolation}},
language = {{eng}},
month = {{11}},
number = {{21}},
publisher = {{MDPI AG}},
series = {{Journal of Clinical Medicine}},
title = {{Efficacy of catheter ablation for atrial arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy—a multicenter study}},
url = {{http://dx.doi.org/10.3390/jcm10214962}},
doi = {{10.3390/jcm10214962}},
volume = {{10}},
year = {{2021}},
}